Fragile

Have you ever known the feeling when you want to do something for somebody so bad that it hurts, but you just cannot?
Have you ever felt so inadequate that it makes you want to cry in helplessness?
Have you ever been in a place when people around you feel hopeless, but you cannot come up with anything to console them?

I have.
Since the past couple of weeks.

I am posted in pediatrics these days. And at times, i am depressed.
Why? Because,
Nothing in medical education prepares us to tell vulnerable parents that their child, the one sleeping on the bed rather blissfully, might not make it until long.
Nothing in all the extensive training braces us enough to stand the grief of a mother (who works 14 hours a day as a coolie, for a less than hand-to-mouth existence) who is told that her child will not survive unless she went through a surgery that costs 6 lakhs of rupees, a sum of money she cannot even imagine there being.
And nothing, absolutely nothing can make us strong enough to answer the question parents dread we would answer in the negative : "Is there any hope, at all?"

One understands that by choosing medicine we have chosen a path that requires us to be a lot stronger than most people our age. But it remains that we are just 21 year olds, trying to pass exams, going through lives as complicated/mundane/hormone-driven as any 21 year olds', and that we do not have any answers.
We might have cut open a dead body, but that's just where our bravery ends.
We might look dapper in white coats with expensive stethoscopes, but that's just where our being doctors ends.

A few days ago, i spoke to a woman whose son had been admitted in the hospital. The son was a cherubic 3 year old with cerebral palsy, the fault perhaps of a local daai, who took too long to deliver the baby, or whoever else's. But one thing is certain, the child had cerebral palsy. A fairly common condition in the wards, and sometimes very crippling.
This particular child had a global developmental delay, meaning all aspects of his development were either retarded or absent. A truth the mother has grown accustomed to be oblivious to. She says the child looks at her, turns his head toward sounds she makes, and smiles from ear to ear when spoken to.
The reason this story is throat-gulp inducing is because all of it is impossible.
The child has cortical blindness, his brains cannot read the images brought by his eyes.
The child cannot hear any sound, let alone those the mother makes. He merely turns his head hither and thither, acknowledging a world only he lives in, a world not inhabited by even this woman who has given her all for this baby, her only one, for the past three years.

What do you tell her when she asks you, "He is alright, isn't he?"
Do you tell her that the apple of her eye does not have the eyes to see you, or the mind to recognize you, ever? Do you tell her this and hope to have the courage to console her?
You don't.
We don't, either.
We say, "Please talk to senior doctors, we are just students", and whisk away from the place to find a strong pillar to punch our clenched fists against. Not because we are incapable of helping the child medically, but because we are incapable of even saying words that would comfort her, albeit momentarily.

Worse is a visit to the neonatal ICU, where little babies weighing as little as 900 grams, looking no larger than the palm of your hand, struggle it out with their small lungs, failing hearts and tightly clenched fists, praying in their own languages, 'please god, please, i promise i will be a good boy'.
With a hundred tubes sticking out all over their bodies, synchronized beep-beeps are all they have for company with the beeps more often than not, counting down their final breaths and heartbeats.

And you merely tap at the glass cabin that is their home,
and feel helpless.

This is a phase every medical student goes through, i guess. This is the stuff hospital dramas on TV are made of, since forever. Only, this is the only thing they get close to showing the truth about.

Over time, we get refractory to this whole phenomenon, i am told. It amuses, or perhaps angers some of my non-medical friends when i sometimes talk of death and illness in a matter-of-fact manner. It angers me, in retrospect, when i think of myself having become thus, where illness is a case to be taken, and death, a figure on the register. But this is the only way i know of being. The system has not prepared me, or any of my friends to deal with situations like these.
Death, to us is cessation of cardiopulmonary activity and non-reactive pupils, as opposed to it being a bereavement and loss of livelihood to an entire family.

If depersonalizing oneself is what it takes to make it as a successful doctor, then may be i will not be one. For, i still feel sad for a woman of 40, whose only chance of being a mother counts its last few minutes on an ICU bed.
I am not saying others do not feel sorry for her. They do, in all likelihood. But won't talk about it, because talking about it makes people think they are vulnerable. And "sissy". And that's anathema, but of course.

This post might seem a little too dramatic and serious, especially as it comes right after a feature on bombshells and thunderthighs. But telling this was essential, to me.
Until such a time as medical science progresses to a state where every patient is cured, we can only do one thing. Hope, and pray. (To a god whose existence, in the wake of all this, seems more than debatable.)

But then, that is all we an do.
Pray for the little children, and their families.
As i am sure you will all.