A Glimpse of Light in the Abyss: A Personal Account
This is a true story from my work experience before entering medical school. It's an experience that continues to haunt me to this day, and this is my attempt to come to terms with it.
"His potassium just crashed!", a distressed voice cried through the hospital line. He didn't need much more; the consultant looked at me and calmly wrapped the stethoscope around his neck whilst shaking his chin from left to right. The ICU that night seemed frightfully peaceful, the low lighting and beeping monitors gave the feeling of impending doom. We entered the room; two doctors and two nurses fixed their eyes on us. One nurse didn't look our way, she was kneeling next to Mr Athanasios*, who seemed as if he was alternating between the physical and metaphysical. "Mr Athanasios, Can you hear me?! Please open your eyes for me!".
There was no time for emotion. "Mr Athanasios, a 50-year-old male, had a routine small bowel resection this morning; he is a type 2 diabetic, smoker..." the list went on. The consultant heard enough. Standing to the right of Mr Athanasios, who was lying naked in bed with a sheet around his pelvis; he started commanding. I can only describe what followed as chaos, healthcare professionals rushing in, some actively helping, others watching; compressions, adrenaline, tangled cables, and disagreements.
"Move out the way! Now!", someone screeched at me, and like shattering glass, it was no longer a movie scene. This was happening; and I was part of it. I moved, paralysed. A young girl peeked through the room window, a pale face with two white lips. I recognised that expression; it was the same the nurse had when we arrived.
An hour had passed, and everybody knew we were sinking into the abyss. Don’t ask me how I knew it. I could feel it. I wondered whether Mr Athanasios' soul had left his body. Had it left an hour ago, or was it still lingering among us? Chills run down my spine. The storm quietened, and the captain called to evacuate; Mr Athanasios was now eternally asleep. The scene was something like a football team who just lost a game against their nemesis, death. Guilt, distress, and paradoxically relief, I was conscious of them all; they were lingering like a bad smell around the room. As we moved outside the room, we faced the real victims. I could not bear to look them in the eyes. I wasn't part of the team, but at the same time, I was. I felt it was my fault; I wanted to cry out, “I am sorry!”.
We moved into a soundproof room; I didn't belong there. The consultant started moving his lips. "We did everything we could..." and screams echoed around. Mr Athanasios’ wife was on her knees, cursing at doctors and gods, whilst Mary, her 24-year-old daughter, held her tightly to her chest as if she was trying to hide, to merge and become one with her mother. I also wanted to become one, one with the ground, disappear, I couldn’t bear the scene. What do you say? There’s nothing to say, but a great much to listen to. You bite your tongue and maybe you say a silent prayer. But however much you want to flee, you stay by their side and let your actions speak I am here for you. It’s easier said than done.
We moved into the lift, it was once again the consultant and me, alone. The air was eerie; he turned to me, exhaled and said, "if they had noticed it 30 minutes earlier, Mary would still have a father". In that moment, the gravity of the situation sunk in. Maybe Mary would still have a father, maybe even then, she wouldn’t. Nevertheless, I got the message. It was a harsh reminder that in healthcare, every second counts and that death can come at any moment, no matter how much we try to prevent it.
As I sit here, I cannot help but feel a deep sense of sorrow and guilt. Two truths are standing beside me; the fragility of life and the constant struggle against the inevitability of death. You might laugh at me, but now, more than ever, I feel the weight of my actions and their consequences. You will ask, what actions? Maybe not those of today but those of tomorrow. The guilt of not being able to save Mr Athanasios, despite all the medical knowledge and resources at our disposal, is a heavy burden to bear. A cross I will inevitably be called to carry. This sadness and guilt, however, highlight the need for reflection and self-improvement. We must strive to do our best in every situation, but also accept that sometimes, it is not enough. Mistakes are part of our human nature - they will happen. But then, how can we not doubt ourselves in every moment? Every action bears a possible mistake, perhaps an unforgivable one.
A friend’s words, though, loom large; If you don’t doubt yourself, you shouldn’t lead. Arrogance is a doctor’s deadly sin, but cowardice can be equally bad. I gather be brave but humble, speak up but listen. I’m far from that, but I’m hopeful I will get there. Dostoevsky once wrote, The darker the night, the brighter the stars, the deeper the grief, the closer is God. In the face of tragedy, we must find solace in the fact that there is always hope for a better future. Through this hope, we can continue to offer our knowledge and compassion to those who come into our care. It is by merging these two fundamental truths, humbleness and hope, that we can move forward knowing that everyday can make us better doctors than what we yesterday were.
I will not forget Mr Athanasios, not because I knew who he was, but because I know what he means to me.
*Pseudopatient names were used to facilitate compassion