Why do we want to become doctors? What was our main motivation that we have written in our motivation letters and repeated in our interviews? Regardless of the specific incident or the general motivation, it can be all summarized in one sentence: We are here to save lives. After all, this is what the physicians do, isn’t it?
Preventing deaths is actually hinted to by the original Hippocratic Oath, written between the third and fifth century B.C. through the following: “Neither will I administer a poison to anybody when asked to do so … Similarly, I will not give to a woman a pessary to cause abortion.” According to the socially accepted norms, the sanctity of life must be preserved by doctors, regardless of the situation.
Unfortunately, when it comes to personal experiences, these slogans are shattered, and the moral rules, that were considered sacred, are questioned. Around two years ago, my grandmother was diagnosed with liver cirrhosis. The drugs she used to take before this diagnosis had their obnoxious systemic effects, leaving her with joint pain, myalgia, and decreased appetite. Add to that the symptoms of liver cirrhosis: jaundice, esophageal varices, spider angioma, caput medusa, anemia, edema … one by one, the symptoms started appearing, as the books and the online sources described.
I was a senior premed back then, excited to read about my grandmother’s disease. However, I could see what’s beyond the dull sentences we read, and the apathetic tables we memorize. Real life patients suffer a lot, and every minor change can be a big deal to them. I followed up with the symptoms reaching the end stage hepatic encephalopathy. The only consequence left was death, and that was when I realized that she had few weeks left.
Like what I imagine the typical Lebanese family would do, my uncles agreed on keep on fighting the disease. They wanted to try every possibility to keep their mother alive. They saw the pain she was in, but the vision of their strong, capable mother never left them. They were fighting to fill the gap between what they wanted, and what the reality is. As expected, no matter what they tried, and what surgeries to “grant her extra days,” my grandmother died a few weeks after the diagnosis.
Looking back, I regret not letting her die, peacefully. I regret the last days of suffering she had lived because she deserved to rest. Now that we passed through the palliative module, I can directly reconnect and notice how much we need palliative care. We need to understand, as a society, that the doctor’s job is to relieve suffering, not to prolong lives. We need to understand that in many situations, fighting is not the best option. We need to accept our failure as doctors, and acknowledge our limited ability in healing. We need to let our patients die, peacefully.
Samer Bou Karroum is a medical student.
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