All That Blood is Just Red
This is the last week of my general practice placement. We usually have little control over which clinic we are placed in, it's the medical school lucky draw. You could be placed in one which is a ten minute walk from your accommodation, or you could be placed in one which has two hours commute time. You could get kind doctors with an affinity for teaching, or you could get doctors who are constantly running forty minutes behind schedule with no time for a measly medical student.
The clinic my friend and I have been going to is a very small one, in a tiny village in Wales. There were exactly four pictures available of the place when we googled it. We had to drive on long windy roads and past an expanse of hills and farming grounds. It seemed like a different planet, a small hidden one protected from the rest of the world. There is just one shop in the whole village and a look out the clinic's window would reveal horses.
The staff and the patients were lovely and we even got to explore the village a little when we got a break between seeing patients. We've befriended the locals, harvested a few spring onions and washed them in a nearby stream.
When we got a little too comfortable, we saw this particular patient. She was a young lady, with doe-like eyes, and an innocent smile. She wasn't much older than me and she decorated wedding cakes for a living. She has never smoked a cigarette nor does she drink. Being relatively healthy, she came in with a couple of symptoms that could easily be classed as 'annoying but tolerable.'
At the end of our consultation, we were waiting for the doctor, so we could present the case and to confirm management plans with the patient. She was showing us pictures of all the cakes that she decorated recently and was telling us enthusiastically how she spends all day making the icing flowers to match the colour scheme of the wedding. The doctor walks in and refers her to the hospital for further investigations. He says, "Let's discuss further when the results are back."
When the lady and the doctor left our room, there is a pregnant silence in the room which J breaks by saying, "It's cancer, isn't it?"
Obviously, we can't tell for sure before the test results. But she had all the red-flag symptoms that they drill into us to look out for in patients.
J and I have seen our share of patients with terminal cancers before. The very first patient that I lost, was to breast cancer. But this patient, she came in content, talking excitedly about cakes and how her husband fell in love with her because of her chocolate buttercream sponge cake. And she was completely and decadently oblivious to what awaited. Not that every cancer is terminal, but even if you tell a patient that the odds of surviving for five years with the cancer is 70%, to them it is 50%. There are two possibilities- life and death. The probability of each is equal, because even if the stats say 70%, you can't predict with absolute certainty whether the patient in front of you will be part of the 'lucky' 70% or the 30%. Sometimes, the patient might even opt to be in the 30% when faced with the battle for survival.
We saw other patients that day, but when we were driving back home, we were talking about her again. We connected with her, we could relate with her, she seemed very innocent and she was so blissfully unaware. At that moment, we could do nothing but stand and watch the atomic bomb travelling in her direction. Her husband must have been at home, eating her cake with nothing but hopes and dreams for their future.
A quote by Kait Rokowski comes to mind, "Nothing ever ends poetically. It ends and we turn it into poetry. All that blood was never once beautiful. It was just red." I wish I could leave you today with an explanation about death and loss. Truth is, I don't know anything but that it would happen again and again, until all of us fall prey to it. I tried to end this post with a feel-good message but I realised it is okay to resist the urge to initiate futile attempts to make everything better and to just sit in the silence a while.
You might be reading this having lost someone in your life in the past, or you might be reading this like the patient we saw, completely oblivious to what is to come and I don't intend to downgrade the pain by fabricating a silver lining. Today, we are going to sit in this story, let the emotions wash over us, feel everything fully in every crevice and let it pass.
With the patient, J and I simply protected that moment and talked about cakes with her until she is forced to deal with reality. At the end of the day, when we put our coats on and stepped out in the wind to head home, I realised that this is the rawest form of practicing medicine, what is left when all the icing melts.
Disclaimer: None of the details in the above story belong to anyone I know. The names (and other details) have been meticulously changed to protect confidentiality.
