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Failing the Oath: When the Messiah Turns Away

Submitted by on November 4, 2014 – 7:21 PM

deathI peeked over the edge to see the Waikato River flowing like a giant worm’s belly. The sun was out for the first time in weeks and blazing the skies, making you almost forget the chilly winter winds. They were putting me in the harness and checking it for my bungy jump into the river’s freezing water. They told me that everything is set and they were waiting for me. “Waiting to do what?” Push myself over the edge for a 154 ft free fall into the raging Waikato of course!

 

The hardest part about it was pushing yourself over the support knowing you were going to fall. Even though they put your legs into a harness, you’re still not sure if it will work. I mean accidents do happen all the time to everyone and not only because someone missed something. There’s a reason they make you sign those health release forms beforehand.

 

With weak knees, I managed to pitch myself over. The wind rushed as gravity takes hold but the impact never happened. Reality comes to call. I’m back in the ward at 2:30 am and the girl is still there.

 

They brought her here because the “Pir Sahib” ‘may have been mistaken’. The girl’s brother tells me his friend’s Pir prayed for her and gave her an amulet for protection. Her worldly medication, lifesaving insulin injections, would of course have to be stopped to observe the Lord’s grace at work. Unfortunately for the girl, she had Type 1 Diabetes.

 

Without her medicine for 3 days and an all she could eat buffet (The Pir allowed it), she was comatose with a blood sugar level of 600 mg/dl (6 times higher than normal) and ragged shallow breathing. Looking at her reminded me of a fish that was out water and gasping for air. Her investigations showed her to be in multisystem failure. This was one memory, I thought to myself, which wouldn’t be easily eroded.

 

A few hours later, she died. But not in peace or comfort, and neither with dignity. I remember her agitated state resolving during this time and this gave hope to her family that she was improving. But I knew what was really happening.

 

She was losing her will to live, and there was nothing I could do to help her. Maybe a senior doctor could have shown up and pulled something through with their experience but this was a particularly accursed time when none of the other 7 doctors were present, including the one guy who promised to be there. I was a House Officer who was stranded.

 

Once something happens, a doctor’s way of thinking goes “why did this happen?” In this case, at least four people could be held responsible, morally if not legally. The Pir, for trying to fix something that wasn’t broken, the patient’s family and guardians for allowing it, the senior who might have done something but never showed up or answered his phone, and me.

 

I cannot speak for the others but the guilt lies heavy on my heart. There’s always this voice at the back of my head that maybe if I had read more books and bigger books instead of watching soap operas, I could have helped. In the back of my head, I let her die.

 

I am a House Officer. I am not licensed to practice medicine without supervision. But I have practiced medicine when there was no supervision and the need was dire. I’m not supposed have duties exceeding 24 hour but I clearly recall pushing 36 to 39 hours.

 

Being a House Officer is like a bungy jump. You accost a new challenge and you’re afraid you won’t make it even though your safety net is well in place. So every time you jump, you make it and you rejoice as you recount your first chest tube placement and how you put the tube in and there was blood everywhere while the family looked at you with pure horror attempting to enjoy the get together they spent weeks planning.

 

Sometimes, however, you don’t make it. What that really means is that your patient didn’t make it. You’re fine, but a part of you died inside.

 

It was 4:00 am and I tried calling the senior again. Thirty six tries with no answer. They put the girl in a shroud to take her home. I wanted to explain to them what happened to their daughter but they stopped me midway saying it was God’s will and his will had been done.

 

I looked at the gurney as they wheeled it out of the ward. I wondered if I’ll be able to save the next one. Maybe the senior will show up and I won’t have to. I am not even sure if the girl had anything to do with her demise.

 

Did she know what would happen to her? Surely some doctor would have described to her what happens when you stop Insulin in Type 1 diabetes. Or did fate play a cruel card and the information was never given to her. Call it fate or criminal misconduct; to me they appear one and the same here.

 

I went back to my seat at the counter, robotically performing all the tasks assigned to me while my mind wandered through time and space. After catching a breath, I was back at the Waikato again. Heart racing as I tip myself over the edge.

 

This time there’s no wind rushing. No sun shining. I’m still in the ward. The “Pir” comes to mind.

 

He must be enjoying the ‘gift’ money they gave him for killing their daughter. A young girl dies, an old man lives. It’s an unfair trade.

 

 

About the Author:The Author is a doctor from Khyber Teaching Hospital, Peshawar, Pakistan.

About this article: This article is competing for the JPMS International Medical Writing Contest 2014.

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