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.

What's your end game?

What’s your end game? A friend of mine asked me this lately while we were in Tunis. I’ve been giving it some thought ever since and I realized I no longer know what that is. I used to be a very determined person. I knew what I want and I planned my whole future accordingly and yes, I always got what I wanted in the end.  That person is so far gone I can’t even remember how it felt to be in control of every aspect of my life and to actually secure a complete success. This is not a sad lamenting post, this is just recognition that as we grow older and move into bigger settings we realize how life actually becomes more complicated and nearly impossible to control as a million new variables come into play.

Some believe that not having an absolute objective in life is a sign of weakness and an omen of eminent failure. I was one of those people at some point in my life. You see we are often afraid of freedom, we tend to persecute it when it manifests in others. People do not want you throwing your nonchalance into their faces. A free thought is the deadliest of all weapons and some communities will fear it to the point of slitting your throat for advocating yours. This is a post mostly about how I learned to improvise and to let the wind take me with it towards whichever shore it desires.  The overly scheming child that was in me learned with time to drop the big issues when it was not my war, to let go of the fights that hurt and focus only on the ones with potential for success. All of that was pointless though; the anxiety will not vanish just because you told it to do so.  It had to be coupled with a few failures for that arrogant child to learn how to let go of the big plans and learn how to live life one day at a time. I did not want this to take such a personal dimension but I guess catharsis tends to do that. I am sure this is not just a personal struggle and that many others have gone through similar fights where we learn to let go of the world and let it lead us for a change.
  

I am not advocating a life of irresponsibility and absolute lack of planning, I am just affirming that my end game is still being cooked up somewhere in the back of my mind for now and that is absolutely fine by me. While growing up I learned how love affairs end, friends turn into lovers, other friends into enemies. Your confidant today might turn into an acquaintance tomorrow. Your enemy (assuming you’re opinionated enough to garner one) is also capable of changing and becoming your ally. Your dream job can turn into a prison for your body and soul, your hobby might turn into your job and worst of all your safety job could vanish and you find yourself on the streets of Beirut. Nothing is static and nothing is guaranteed. I could drop dead any day now from a rare cardiac cause. I could win the lottery tomorrow and find myself capable of finally touring the world with someone I love (I think this item should be on everyone’s list of things to do before they die).  Where am I going with my life? Honestly, I have no clue. It has never been gloomier. I believe this question cannot be answered at any age whatsoever because having one end point will prove you see an actual ending stage for your life. If the finality is to get married and have children then why bother with a career? What about the 40 extra years which come after marriage? Are they all just one point in time?  If life is about getting rich then when will you have time to spend that money? Can you really share with that money the memory of how you got it? 

In the end, uncertainty is a hidden treasure. Not knowing only means you have eyes wide enough to see the whole horizon and pick whichever element you want out of it. Although it is an ingredient for success but determination butchers the imagination. We all have to figure out an end point at some stage in life but we have to get along with it an escape plan, a comeback mechanism, something to help us keep our sanity if the endpoint is never reached or even more often, something to remind us there are still other places to get to once the first endpoint is reached. As a final thought to those still thinking of end games,  keep in mind that life is a lengthy process about creating yourself and having the end result before hand certainly kills the fun.