Physician, Heal Thyself

Last year, I read the Pulitzer nominated book ‘When breath becomes air’, a non-fiction autobiography written by Paul Kalanithi. It was published posthumously, after his long battle with lung cancer. In the book, he narrated from a doctor’s point of view, about his struggle with the illness and the constant clash between hope and hopelessness. It was a beautifully written heart-breaking book.

Many a time, we hear the popular joke: ‘Doctor, even you?’ ‘How can you be ill?’ and my personal favourite ‘Ha! God don catch you!’. Sometimes, I laugh over it, other times I just ignore their sarcastic barbs. People need to know: Doctors are human. And even more so, because we are not protected by the cloak of ignorance. When a doctor is diagnosed with Liver cancer, no amount of reassurance or statistics or discussions on newer treatment methods will deter him from breaking down psychologically. The doctor knows, he will not survive it.

I remember my friend’s death like it was yesterday. It was at the beginning of our residency program, and she had just started hers in the southern part of the country. We would often call each other and swap stories on how hard residency was, balancing work and family and our dreams of someday making it big in this country. Ha! We had such tall dreams, Damilola* and I. That is, until Life happened.

It started with complaints of headaches. My first mistake was to dismiss it as the normal tension headache. ‘You too dey complain’ I would chide. Take some pain killers and sleep it off, I advised. Later when they became too frequent, I asked her to take her annual leave. She had not taken her leave in two years because she wanted to complete her residency program in time. This was not unusual for resident doctors. She had also put off having a baby until she became a consultant. Her husband also felt the headaches were due to stress, and so she went on leave.

Mistake number one happens a lot. If a patient had come to me and said he or she was having repeated headaches, I would have ordered for a brain CT immediately. However, when a doctor come and tells you the same thing, our first instinct, as colleagues would be to brush it away and think of a simpler reason. Subconsciously, you forget you are human and think that “those” diseases you read about in textbooks only happen to others and not us. Additionally, because most doctors are often suspicious about the diseases they read about, whenever they are sick, their colleagues simply put it down to paranoia or the so-called ‘Medical student syndrome’. Doctors do not follow proper protocol where colleagues are concerned.

After her leave, her husband told me that she felt better. She however confided in me when we spoke, that she had gone to see the Neurologist as she was still having the headaches but had stopped complaining to her husband as he was becoming increasingly irritated with her frequent illness. She was taking stronger and stronger analgesics to mask the pain. She did not want to seem weak as our exams were just around the corner.

Mistake number two: Doctors self-medicate. We are all guilty of this. Instead, of going to a doctor and being properly evaluated or after our symptoms have been belittled by our colleagues, the next thing is to start treating or evaluating ourselves. I do not need to tell you how dangerous this is.

One morning, as I was getting ready for work, she called me frantically weeping. She had noticed a small dark spot on her left foot. She did not know how long it had been there as she had never noticed it before. She usually took her bath in under three minutes. Time is a luxury resident doctors do not have. What could it be? She asked me. We both knew what the answer was but none of us could voice it. Damilola’s father had died of Melanoma, a type of skin cancer, in his forties. I reassured her and asked her to see the dermatologist immediately.

She called me days later and broke the sad news. Her headaches were as a result of metastases (spread) of the skin cancer on her foot. It had been there for a long time but she had not noticed it. Her family was devastated. She had cried herself to sleep for days.

Mistake number 3: Doctors neglect their health. We do not take care of ourselves like we preach to patients. Doctors hardly go for the annual medical check-up that is required. A colleague I know has never had a pap smear! Damilola, despite her strong family history of cancer should have been extra vigilante about the disease. Instead, she neglected it and was only diagnosed after it had spread.

The news broke me. I was in my third trimester of pregnancy and so could not travel. We spoke daily and I tried to reassure her. We both knew however, that the end was near. We talked about our tall dreams and ambitions, our achievements and our regrets. She regretted not having children and putting her life on hold for Medicine. She regretted so many things which I now realise is mistake number four. As humans, we all hope to live a long fulfilling life, but doctors particularly, due to our ambitious nature, often forget to enjoy the moment and put off living until after a particular goal. We forget that death can come at any time.

To all my colleagues who have stared death in the face, may God judge us based on what we have done for mankind.

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