Hospital moments that reshaped my view of humanity.

A few days ago, I finished my third year of medical school. That year was also my first fully clinical year i.e. I spent all of it on hospital grounds. Physicians are often put in situations that challenge their humane side. I have probably learned more by passing on the hospital floors about humanity than I have in the past 24 years where I amassed friends, enemies and idols. I have learned much more about the value of a life than in all the humanity courses combined. I have learned even more about the absurdity of it than from reading Sartre, Camus and Ionesco. Looking back on these 12 months, I wanted to note down some of the most intense moments:

 -Seeing my first embryo on ultrasound and having it turn out to be dead.
All the arguments I have had pro or against choice suddenly became irrelevant. I am a deep believer in the right of a woman to terminate a pregnancy but standing there, I had to admit, it did not feel right at all. I still think however that if she could go through with it, it is her choice but unlike what I had previously thought, I would think twice if I am ever in a condition where the fetus has half my chromosomes.   

-Diagnosing a 3 year old kid with advanced cardiomyopathy requiring transplant.
Looking at the confusion in the father’s eyes as the doctor begins to explain to us in a not so discrete tone how this child is destined to die if he does not get a transplant.  

- Hearing the inspiring recovery story of a drug addict my age.
This has by far been the most inspiring moment of my medical path so far. It is both destabilizing and reassuring to see a young man take control of his life and turn an extremely horrible situation into a success story.   

- Carefully approaching the parents of a possible abuse victim.
How can you explain to parents that it is very likely someone close to them has sexually abused their daughter when she was barely 5 years old without reconsidering the value of humanity. 

- Soothing a young girl after learning she got her infection from the man she thought she loved.
Imagine her crying as you told her that he caught this from someone else and transferred it to her when she thought he was faithful.

-Seeing and smelling the blood of a teenage trauma victim as it sprays all over your white coat, and ultimately losing that patient.  

- Meeting uneducated empowered women who overcame more adversity than you can imagine and argued about feminism, equality and metaphysics without having read about it in a book

 -Watching the truth being hidden from a man with cancer and vaguely answering his questions when he asserts you're his favorite part of the medical team. What can you do in a society that refuses honesty and claims it is in the greater benefit of the patient?

-Gazing into the eyes of a paralyzed speechless man as he moaned begging not to be fed by a tube. How much is left of you if you can no longer express yourself? You’re just a consciousness stuck in its place, incapable of drifting away as those around you forget who you were.  

- Hearing the screams of a patient with cancer in the bone. Never will I forget the plead for help as I stood there speechless after all the possible pain medication given was in vain.

  

- Trying to understand how the patient who makes perfect sense at day, deeply cuts herself with any available item at night. Mental illness is not a joke to be fiddled with. It is a very frightening notion not to be able to control the full spectrum of your emotions.   

- Watching daughters instantaneously shift from pleasant polite ladies to irrational, shouting insane women when talking to you about the well being of their dying mother. I think this is my closest encounter with the pure form of what they call love.

- The intense fear when finding similarities between my life and the story of a schizophrenic patient.

Beirut Vs. Change

Today I actually decided to post my original first piece. I had planed on using the following text as the first post for my blog. Yet misfortune happened and a significant bombing occurred that day which is how my first article “A guide to Beirut bombings” came to be. Before reading this piece you should keep in mind that I wrote it while in my psychiatry rotation and I was in a rather different mindset than today since so much has changed in the last 5 months, much more than I can describe by typing on my laptop.

While I was passing through the psychiatry rotation in my training as a physician I often came across humans in their weakest or strongest states. I was amazed to meet humanity in its outmost will power, its weakest downfalls and its painless dissociation. It's not that I am coming from a absolutely sane background, as a matter of fact my network of family and friends has in itself a big spectrum of dysfunction but what lacks is the distance I need to objectively appreciate what I'm seeing.

Splitting from reality is an intimidating notion isn't it? What If your reality was too cruel to live in? Would you take schizophrenia over reality? Of course not! Right? Well tell me, what's your definition of reality? Is life about the outings? The money? The job? The Good sex? The friends? The children? The family? Why is your life worth admiring and that of a schizophrenic pitiful?

In a nutshell schizophrenia is an organic disorder of thought where patients lose touch with reality, hallucinate and develop bizarre fixed beliefs ranging from magical thinking to absolute nonsense. They are often so convinced of their speech that you are inclined to consider if it is true or not. Imagine the horror when in the midst of his delusions, a schizophrenic patient reminded you of your own life and struggles and you are left with a scary notion: am I going to change my thinking process or will I one day split from this reality and have the life I always wanted to live, believe the things I always wanted to believe in at the cheap cost of having all of this only inside my mind.

The code of confidentiality keeps me from going into any details but it all started when one patient rightfully evoking his struggles seemed to mirror a recent debate that had been raging in my mind, the dilemma of change. Just like schizophrenics, we tend to rationalize change in the weirdest way possible.

There comes a time where you look around you and realize the people are not the same, the room is a new one, the weather is milder and you are trying to convince yourself you have not changed. Do me a favor, grab a mirror and look in it to see if you could name the person in the reflection.

Living in Beirut, one comes to realize escape is not an easy option. You can rarely

drop your past and start over. Off the top of my head, I can list two reasons for that: one is that the city’s too small to completely change scenery and two is that the culture is too meddling to just let you be. Here’s a fact, in Lebanon, it is not uncommon to still be extensively in contact with the same set of people you grew up with. After all, half the population lives in an area as big a one or two districts of Paris. If you’re wondering, Paris has 20 districts.

I personally love to study people. It is possibly one of the many reasons why psychiatry is high on my list of possible specialties after I finish my training in medicine. I liked to observe and analyze the behavior of friends, family and even acquaintances ever since I can remember. In that process, I came across many ways residents of Beirut have embraced or at least tried to embrace change. I personally have gone over many transformations, tried many approaches as I eventually came full circle. I think I realized why most of our youth resort to immigration. Yes it is true that finances are the leading cause for people to leave, nonetheless, it seems traveling is a corner stone in the development of every Lebanese youngster. We travel because we are suffocated by the small space and smaller circles of society. The chains of the Lebanese community tighten further as you grow up till you realize, like I have, that escape is inevitable unless you want to become another pawn in the sectarian corrupt community. It so happens that you find yourself changing from within, your mind shedding its older notions and preconceptions but the city around you seems to be more resilient, after all, it is too small to accommodate the changing whims of all its inhabitants. This is when a good proportion of its citizens become entrapped by the will of the majority and changing that reality is hardly possible without extreme turmoil and resistance from the masses.     

That identification with the schizophrenic happened a couple of times already in the past few weeks and it got me thinking, why am I finding common grounds with someone whose feet haven’t touched the land of reality since the 90s? It’s probably because if I don’t get the chance to free my mind from Beirut’s preconceived notions of what life should be, I too will turn the outside world into my own personal view of reality.