What would you give?

46501802_303695647150855_2339079411770327040_n.jpgToday, like most other days, was soiled in all sorts of different emotions, which brought many different dimensions to reflect upon this evening.  It was a day of tears, memories, flashbacks, insights and frustrations.  But it was also just another day at medical school.

As part of my Oncology placement block, I attended some workshops, where I practiced and learnt the ways in which healthcare staff break bad news to patients and/or their loved ones.  It without doubt required an entirely new level of communication and critical feedback, but also an alternative perspective into the forms of ‘bad’ news – whether that be death, dying or ‘the next steps’.  One of these ‘next steps’ concerned the topic of organ donation, particularly here in Wales.  Last year, 400 people died whilst waiting for an organ transplant, whilst there are currently 6,000 patients on the UK Transplant Waiting List, according to ‘NHS Blood and Transplant’ page.  Yet for every 1 transplant, we can save 8 lives, according to UNOS, transplant statistics for the U.S.  In Wales here, we are adopting an ‘opt in, opt out’ system, whereby we are all automatically registered to donate our organs, if we die, unless we otherwise say so.

These numbers are incredible, yet the initiative of the organ donor system is life-changing for so many.  But the whole concept of organ donation today hit me rather hard, for personal reasons, to say the least.  My recent admission to Intensive Care, whilst on holiday in Italy this August bears very little memory of any of the events or surroundings.  Intubated for 13 days, septic and delirious, I can only vaguely remember the toxic white whir of the hospital lights, and the heavenly clinical fog, a stuffy, stale fume of air hanging low in the Critical Care Unit.  But what I do have of a very disjointed recollection on my last day in ITU, before being transferred to another ward, was a fast-paced panic and buzz very close by.  In fact, it was the patient in the adjoining room, next door to me.  Whilst my bed lay in the very open of the unit, accessible for all eyes from the working desk, this patient lay in a closed-off side room.  The patient laying there was dead.  I did not know who or what they were, but all I knew was that this poor patient had only very recently died.  Very recently.  Clusters of doctors scurried to and fro from this patient’s room, dressed head to toe in white overalls and long coats that flew and flapped as they paced in and out of the corridor.  They were carrying big white boxes, seemingly sealed, each time they came out of the room, leaving the patient lying there.  That patient was an organ donor.  And, in those big white boxes, sealed, were the patient’s organs, ready to be whisked off to another corner of the hospital to be transplanted into those so desperately waiting for a new lease of life.

The workshop had suddenly given me a pitting sensation – a churning flashback of what I saw and what I knew.  A very vivid reminder of how sick I had somehow gotten in the process.  At this point in the discussion, I had to swiftly leave the room, out of control and burst into tears.  My emotions of that summer had finally given way at the most unexpected and stable of times.  Until this morning, I hadn’t realised how affected I really was by all of this.  Now it is a perfectly natural thing to do as a doctor, to break down and respond with emotion and fear, heartbreak, justification.  If we didn’t have or show these emotions then we would certainly be in the wrong job.  And, although I may’ve slipped away a bit this morning, gushing this all out also reminded me that actually, I still had a lot of empathy to give as a future doctor – a lot of insight, and, most importantly, a heart.

This goes back to another blog I wrote earlier on this week about insight and eyesight.  Following the workshop this morning, we had another session in the afternoon getting our hands on how to establish and use syringe drivers in the pain management of patients nearing the end of their lives.  Yet again. I was faced with a secret discrimination by more than one member of staff holding the session.  I was faced with rudeness, dismissiveness and a somewhat ‘snappy’ mannerism as if to say I was worthless and incapable of being there in the first place.  What’s more, no other student appeared to be spoken to in this way.  Was this because they know I am disabled?  After the session, a few students approached me, voicing how appalled they were to see that I was treated like that.  I guess though I have become so used to it that I sometimes don’t bat an eyelid – just how these staff members never bat an eyelid when they spit words of discrimination at me on a day to day basis.  As to my fellow colleagues, students – at least they still have hearts.

I brushed across this mural down an alleyway in an off-beaten part of San Francisco two summers ago.  As a medical student, the (almost) anatomically correct painting of the human heart naturally caught my eye.  Signed with ‘Por Vida’, meaning ‘For Life’ in Spanish it has many metaphors and definitions drawn to it.  In the instance of today’s organ donation topic, on one hand, it gives patients on the organ transplant waiting list a message of hope for a new lease of life, for life.  It reminds us that we all, well, most, have hearts and that we all have emotions, regardless of how cold, snappy or dismissive we may appear from the outside.  And for me, these emotions, will likely stay with me for my whole career, my whole life.  The arrow piercing through this heart signifies the fact that I will permanently have that experience of ITU and the dying patient next-door who donated their organs, embedded into my heart.  This, along with many other of my experiences, has given me insight, like it did today, and naturally, I have to accept that my emotions may bleed a little every time that arrow hits me personally, in the clinical environment.  Above all though, it has reaffirmed that I possess a particular level of empathy that gives me the insight that so many other people otherwise neglect and dismiss because of the physical absence of insight – my ‘eyes’.  Today, I checked in with that empathy, but I also double-checked that I was on the list to be an organ donor, because I have decided to opt in.  What then, would you give?  Would you give your heart?…

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