starting over at the end

Sept 2013

I’m back to medicine – in a haematology unit. Leukaemia, lymphoma, multiple myeloma. Hence I’m thinking a lot about my own death and the fact that there is maybe a 30-40% chance it will come with crumbling bones and bladder dysfunction, and almost certainly at what appears to be an inopportune time. I’ve thus far been blessed with good health and because of this, it’s easy for me to think on death and imagine that I am “mindful” of it. I can think of it as the mystery to come after – we all learned as children from Hook “death is the last great adventure.” I’m sure I’ll feel very differently when it knocks. If it does. It might just blow in the door.

Who said that humans are the only creatures who know they are going to die? I am going to die. I am going to die. Nope, can’t process it. To lie there, a pair of eyes looking out at everyone, while my body collapses around me and becomes completely foreign in its appearance and function. I am trying to understand these middle aged men, their wives sitting too upright and gripping the sides of the chair white knuckled. The retirement plans have changed. They are continually touching it, the constant reminder every time they turn their heads, the hard little grape against the jaw. They imagine that it’s shrinking. I can’t speak about the sickeningly young.

Those I love cannot be here. Their bones are too precious. I can’t think about their skeletons as a single crushed vertebra on an MRI scan signalling something else. As part of some learning on multiple myeloma I read some blogs. Most of the blogs I found stopped posting after a couple of years. It’s too eerie to hear those voices silenced, let alone the voices of my own family and friends.

In riding around Argentina shouting at cattle and unmindful of my cervical spine, I had forgotten about this side of life. The grey faces, the swollen legs, which people look at in wonder as though disbelieving that they are theirs. The never ending list of things to be done to you – there is no participation in hospital procedures, you are always the object of the sentence. The endless endless shortage of breath. There is never enough breath to go around. There is always more paperwork, more phone calls, and never enough talking. To the patients I mean. We talk to each other endlessly. The emergency doctor tells the registrar, she tells me, someone tells the boss, I tell the nurses, the patient tells the nurses something different and off we go again. Everyone has an opinion, everyone has a story about what they heard the dying man say in his delirium.

In a society with next to no ceremonial rituals, we mostly feel the same pressure to remain by the door for a moment after we’ve left the room, to talk about things of no help to the dying person or ourselves, to grunt agreement to the inane statements of our colleagues. We pay our respects by standing in a circle and talking in low voices, with an occasional pause, about how poorly the family understand the prognosis, and did you see how well groomed the wife always is? We tend to gossip about what happens to people in their last days, to pay homage against our own deaths, coming soon to a hospital near us.

I thank my urinary tract when I go to the toilet around midday . What a lovely, daily blessing, the humble muscular bag letting out the intensity of the preceding five hour ward round with wondrous functionality. There is a flux and flare to this business, this living and then dying, and for now I have my part to play amongst the living. There are forms to fill, phone calls to make, people to love, for I am going to die.


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