Medical speak is fun.

"Nil evidence of sinister pathology" sounds more professional than "there is no need to worry",
"Domiciliary acopia" sounds more intelligent than "not coping at home",
"Intravascularly replete" sounds more diagnostic than "not dehydrated",
"Circumlocutory historian" sounds better than "I wish he could just get straight to the point",
and "Diagnosis not otherwise specified" really means "I have not much idea what's going on".

It is also interesting how different terms come together to form a completely different language. When reading the pathology report for a patient with suspected bullous pemphigoid:

There is a superficial perivascular lymphocytic infiltrate and a marked interstitial infiltrate of eosinophils within the papillary dermis, associated with overlying epidermal focal spongiosis ... Included in the differential diagnosis is hypereosinophilia syndrome, drug reactions and possible arthropod assaults.

I seriously laughed out at "arthropod assaults". It does indeed sound cooler than "check if the patient's infested with lice".

But it's not that funny anymore after looking at some pictures of arthropods.

It is strange to see young guys and girls in the hospital - but I saw a couple of them in a row on a Monday night while working in the Emergency Department. They had all come in suffering from terrible cold/flu symptoms in this rainy winter and swine flu scare.

Those poor souls all looked absolutely miserable, I have to say, but they had nothing to warrant admission into hospital. So I said sorry and sent them home.

I remember thinking to myself as I walked out of the ED consult rooms - that I better not get sick after being in close contact with them!

And who would have guessed, the next morning during the post-acute ward round, I sensed an itchy throat creeping up. That very night and the following two days, my nose was running like a tap, my eyes were watering like a poor lemon being repeatedly squished, and I was madly sneezing in spasms every couple of minutes. I was practically bed-bound in a dark room, constantly feeling like tearing my sinuses out. I haven't had a cold/flu as bad as this for years!

Oh boy, how am I able to be a front-line doctor, if seeing a few infectious patients knocks me down completely for a few days and renders me weak like a kitten for a few days more?

I am at least glad I am recovering, by God's grace. Strangely I now feel like a special survivor.

It is wonderful, too, to be able to walk around comfortably without being sick.

What if you (or your wife) had just got pregnant - but, by some reason difficult for us to understand currently, was diagnosed with a breast cancer.

Chemotherapy is necessary, but it is also very rough and teratogenic - it will not go well with the expecting mum and the unborn baby. The problem was big and demanded a decision.

Here are two real stories about this - about real people in their real struggles:

1. Mum and dad decided to bite their teeth and carry through with the pregnancy without chemotherapy. The cancer spread in mom and she deteriorated quite badly over the course of pregnancy. Still she managed to barely reach 32 weeks when she was rushed to the delivery suite. She gave birth to a premature little baby boy via Caesarean section, and then received urgent chemotherapy in the delivery suite, then and there. The baby boy made it into the world alive and healthy, but mom passed away shortly a year after. Dad was left alone to take care of the newborn boy.

2. Mum and dad decided for an abortion. The lead-up to the abortion was fraught with many uncertainties, but the actual procedure was over way too quickly and easily. Mom and dad turned up together to the Cancer Centre a week later and began the chemotherapy cycles. The disease was as well-controlled as you could expect in modern oncology - but not without some sense of guilt that may never leave, no doubt.

But which is the right decision? Many circumstances in our lives are often just too hard for human wisdom. That is why there are so many regrets.

Four o'clock in the morning.
Five hours into the night shift. It has been so stressful.

I almost entered a cold war with a nurse (How embarrassingly childish, I know, sigh...).
My hands shook like a wimp when I threaded the ET tube down the bougie into the
lady's trachea.
I felt like a complete idiot after speaking in circling thoughts to the medical registrar.
I found I had nothing to offer at all, having just certified an old woman dead with her husband
sobbing harder and harder beside. I've never even known what to say in these situations.

This is totally not about the grandeur of doctors realizing how little humans can actually do,
But rather how little I know - how unable and how incompetent I am,
And how frighteningly unloving, unjoyful, unpeaceful, impatient, and unkind I can be,
When dealing with all sorts of people, in all sorts of situations, four o'clock in the morning.

In between the days and nights when things are going smoothly and happily,
I really thank God for this realization.

It makes me go back to Him.


--


( 3am in the hospital corridors, on a less eventful night! )

We asked if she smoked. "No," she answered flatly. "I stopped. A year ago." A glint of pride in the accomplishment, it seemed, flashed across her face with that reply.

But it was too ironic.

She was definitely not alone. In fact, too many are just like her - smokers for all their lives, who suddenly (and finally), out of their own intentions, quit smoking, only to be hit by a diagnosis of lung cancer shortly after. We see this again and again. Why do so many smokers stop smoking just before they get lung cancer?

Not all admit when asked, but often it is because they could feel that something was going amiss, and so they stopped in alarm. It might be some blood specks coughed up, or some strange weight loss that had worsened - not enough to make them see a doctor immediately, but enough to scare them to think, "Gosh, all my cigarettes may actually kill me one day!!"

But it is already too late; and what is done is done.

It is easy to point at others, but there are some things too - small and big - that we - all of us - keep doing, despite knowing they are wrong. Of course we pay, in the end.