Tempestuous ;;

and when she speaks

Monday, March 30, 2009

Last Friday, I managed to squeeze in time to meet up for a short while with dear ol' Haslina, then with Eugene and Evan for a bit.

*yay* In two weeks' time, we'll be heading down South for a wedding :)
I can't wait.

I love attending weddings and birthday parties :) It's a great excuse to doll up and look pretty and meet all the cousins whom we haven't seen for ages!

Unlike my cousins' reason; hers is to 'kap chai' & be on the lookout for cute boys -.-' oh brother* ;)

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12:20 AM;;

Sunday, March 29, 2009

I have seen how the body is severely ravaged by disease. Seen patients suffer from unimaginable, undescribable cancer pain. Seen a grandpa crippled and broken with all his limb bones literally hardened in permanent flexed fixture who had to have his thigh bones pushed apart with as much effort as possible to have a needle inserted near the groin area for venous access... As I watched him writhe in pain, his two fingers squeezing and holding on for dear life onto his urinary catheter, I could do no much more than hold his other hand tightly whilst he gripped it and cried silently in pain... Inside me, I felt my own tears welling up, but we had to do this... I couldn't hold back and left when they've successfully inserted a femoral line, and left to wipe my own tears by the nearby toilet. I've watched patients who are reduced to an invalid when they used to be robust and strong; barely mobile; barely able to walk beyond their bed to chair. Patients' who are unable to utter a single corrigible word. Patients only a fragment of their old self in the physical form; with their mind now- just a space for irrational, uncontrollable, primitive thoughts when cancer infiltrates the brain.

This is why I'm so pushed. Even if there is no cure, it is my responsibility to comfort. And that is the essence of palliative care.

In those fleeting moments when my mind wanders, it sometimes falls on images of those patients whom I've met- those whom have etched a mark in my memory and will serve as a reminder for me to never become jaded. To remind me why I'm here. To ensure I always give my best and look at my patient as a whole, taking into account not just the physical; but the psycho-social and the spiritual aspects of them as well.

My talk last week was on 'the holistic approach to a dying patient' and in the process of being so engrossed in researching on that; I discovered and learnt so much.

"Are there specific things that you would want your family to know about you, and are there particular things you would want them to remember? Are there particular things that you feel still need to be said to your loved ones, or things that you would want to take the time to say once again? What are your hopes and dreams for your loved ones? What advice or words of guidance would you wish to pass along to your loved ones? Are there words or perhaps even instructions you would like to offer your family, to help prepare them for the future? "

From Chochinov and friends' Dignity Psychotherapy Questionnaire Protocol where questions like these are asked and then taped; and returned to the dying patient as a tangible product; a legacy document that is usually bequeathed to the patients' family once the patient has passed on.

Nowhere is the adage "to cure sometimes, to heal often, to comfort always" more salient than in end-of-life care.

In accordance with the vision of the late Dame Cicely Saunders, palliative care "will do all [it] can, not only to help you die peacefully, but also to live until you die."

I'm thankful I chose to do a hospice elective, a palliative care elective in New York and a geriatric elective in UMMC- I have been fortunate enough to learn how to ease suffering and comfort dying patients. and their concerned families.

To the people who have taught me humility, courage, strength, optimism and perseverance; thank you. Your gift of life served as an inspiration to many more, I'm sure.

her
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9:48 PM;;