So while my tired eyes are screaming for me to shut them, I must empty my mind again of thoughts and since this blog has served that purpose well in the past, I can trust that it shall do so again.
Now, that I am a mere two months away from my final MBBS qualifying examination, I feel as always the deep disquiet that accompanies the insecurity I occasionally feel about the matter of actually being able to treat real patients. I have determined that around three times out of ten I am able to reach a satisfactory diagnosis by a process of thinking that will obviously require great refinement that I hope maturity and experience will supply. I have also studied somewhat sufficiently and trust in myself to be able to devise some kind of method of management most of the time, except in emergency situations where I have found I dont possess enuff calmness to proceed without anxiety.
Today, my professor told me that he thought I was a good student and then he asked me how much I have been scoring these past few years. I told him I had scored 75% exactly in my first year, nearly 73% in my second year and a little more than 71% in third year. He smiled and said, "How much do you expect to score this year?" I replied that I just hoped to pass, which is true. He said something that I'll remember forever, I think. He said something like "Madam, if you score 75%, there is still a deficit of 25% when you're dealing with human life. Isn't that rather a lot?"
I had not thought of this. I replied that there is a certain reasonable expectation of knowledge and skill from a good doctor and I hope to reach that expectation and that is all. He said he agreed that doctors aren't superhuman computers and are bound to make mistakes, but the cost of every mistake is disproportionately high.
He wished me luck for my final examination and I walked out, quite paradoxically anxious, instead of being flooded with end-of-exam relief as I had hoped I wud be.
This was not the only incident that affected me these last several days. On the day of my surgery exam, a lady with a grossly enlarged nodular thyroid, put her warm hand on my arm when I sat down beside her to write her case down. She asked me if she was doing the right thing having the operation done becoz her family discouraged her and this scared her. I assured her that she was, and that the surgery wud help her. I sensed acutely the fear she felt when she pressed her fingers harder into my arm. I held onto her hand while I proceeded to write her case, I only left her side when the resident in charge of the exam told me the time allotted to me was up. I said to myself, I had reassured her effectively but I cannot be certain.
The second time something deeply affecting happened was in the paediatrics examination yesterday morning. Paediatrics is always hard, I find it painful to watch children suffer. It just seems so unfair. This 11 year old girl with a previous history of TB lymphadenitis had developed sudden-onset hemiplegia and motor aphasia. While I questioned her mother about how it started, the mother grew increasingly agitated as she described her ordeal in trying to get her child admitted to the hospital and how it took eleven hours for the process to be completed.
Then as I asked her about the child's development, she told me how her daughter was the most intelligent of her five children. She teared up and told me, "Meri beti kitni achchi hai. Usko aisa kyun hua? Woh abhi baat bhi nahi karti hai. Doctorsaab, woh theek ho jaayegi na?"
This really tore at my heart. I told her to be strong and that the doctors here wud do everything they cud to help her child.
I watched my batchmate who was allotted the same case, interrupt the mother repeatedly to write the history down in a hurry and I realised how easy it is to become so utterly desensitized towards another human being's agony. And how it is also easy to forget that they are human beings at all.
I have tried, all these years, to be as considerate and as kind as I possibly cud. I have watched my father and my own paediatrician interacting with their patients and I hope ardently to be as good as them some day.
I know that my conscience shall hold me forever answerable and responsible if ever I go wrong with anything. And knowing this scares me.
But I am thrilled to think that I shall help to relieve suffering, if only fractionally. I am convinced that I shall always try.
I dont know if these qualities will make me a good physician some day, but the answer is in the attempt.
When I told my best friend about these patients today, she smiled and told me, "You know why they talk with you. Becoz they can sense that you really care."
She is right. I do care. I pray I dont turn jaded or casually cruel or even rude like the few people I have seen who are that way.
At the same time, I cannot give myself over to studies entirely. I must pursue all that I love or I shall become a mean, incomplete person. I can also never ignore the deeper calling that asks me to examine philosophically the matter of suffering and death. I cannot stop myself thinking about it. I hope that I can be rational and useful inspite of it.
Please, please, the powers-that-be, please let me be successful in this much.
I really admired that Talmudic saying that is the title of this post. It was inscribed on the ring that the Jews that Schindler saved, gave to Schindler at the end of the war. I really want to believe in it.
P.S. I just read this back to myself and I think the tone is a little detached. I wonder why that is, becoz I have only sometimes experienced such turbulent emotions before. Perhaps now I shall be able to sleep.