There’s still something missing within. I’m still looking for it.

| 29 December 2018 |

The final year of medical school kicked off with the infamous Nephrology rotation (the Ziauddin alumni will understand why I have used the term ‘infamous’ here!) and in retrospect, I’m rather glad for it. With her no-nonsense attitude, the very competent consultant expected us to shadow the house officers and that – for lack of a better word – shepherded us towards studying strategically. But there’s more to it that, obviously.

One patient to the next, interpreting arterial blood gases and chasing lab values of patients on end-stage renal failure; somewhere along the way we also learnt the importance of making wise, patient-friendly decisions. The consultant that we were rotating with, had a zero-tolerance policy for unnecessary lab tests ordered by her residents. With health inequity prevalent as a huge problem in a country like ours, it’s peremptory to realise that majority of the patients delay or avoid treatment because of the expenses of the tests required for diagnosis and the proceeding treatment. While all these tests are necessary, an equal emphasis is to be made on the signs and symptoms that the patients present with. While it’s easy for a senior consultant to differentiate between the absolutely necessary and the avoidable ones, to expect your subordinates to make decisions at par with your level of expertise, is, of course, a little too much.

What really hit me, though, was the ferocity with which the feeling of losing a patient crumbles you. Of course, declaring deaths is something that doctors often have to do hours apart, even. But how do you guard yourself? That small piece of yourself that threatens to desert you every time you lose a patient? This question knocked at my door when I turned up at the M.I.C.U. one early morning to follow up on my patient only to find the bed occupied by an unfamiliar face.
“He expired last night.”
“Oh……….inna lil la ha wa inna ilaeye rajioun.”
(“We belong to God and to Him we shall return.”)

I went home later that day hoping – praying – not to be scared of my own death, to do enough good to look forward to it like an old friend, and to not let a ‘daily truth’ like death take away from me who I want to be.

There’s still something missing within. I’m still looking for it.