Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
Author Reply
Book Review
Brief Communication
Case Report
Case Series
Clinical Case Report
Clinicopathological Conference
Commentary
Corrigendum
Editorial
Editorial – World Kidney Day 2016
Editorial Commentary
Erratum
Foreward
Guidelines
Image in Nephrology
Images in Nephrology
Letter to Editor
Letter to the Editor
Letters to Editor
Literature Review
Notice of Retraction
Obituary
Original Article
Perspective
Research Letter
Retraction Notice
Review
Review Article
Short Review
Special Article
Special Feature
Special Feature - World Kidney Day
Systematic Review
Technical Note
Varia
Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
Author Reply
Book Review
Brief Communication
Case Report
Case Series
Clinical Case Report
Clinicopathological Conference
Commentary
Corrigendum
Editorial
Editorial – World Kidney Day 2016
Editorial Commentary
Erratum
Foreward
Guidelines
Image in Nephrology
Images in Nephrology
Letter to Editor
Letter to the Editor
Letters to Editor
Literature Review
Notice of Retraction
Obituary
Original Article
Perspective
Research Letter
Retraction Notice
Review
Review Article
Short Review
Special Article
Special Feature
Special Feature - World Kidney Day
Systematic Review
Technical Note
Varia
View/Download PDF

Translate this page into:

Letters to Editor
23 (
1
); 77-78
doi:
10.4103/0971-4065.107220

Close encounter with destiny: Lessons learnt

Department of Nephrology, Apollo Hospitals, Secunderabad, Andhra Pradesh, India
Address for correspondence: Dr. S. Krishnan, Department of Nephrology, Apollo Hospitals, Secunderabad, Andhra Pradesh - 500 026, India. E-mail: poojakrish54@yahoo.com
Licence

This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Disclaimer:
This article was originally published by Medknow Publications & Media Pvt Ltd and was migrated to Scientific Scholar after the change of Publisher.

Sir,

Three days of symptoms – severe abdominal cramps, constipation, and mild distension. That's it. I was in for a deep shock. As the gastroenterologist decided to perform a sigmoidopscopy in an unprepared bowel, my thoughts were racing. I kept reassuring myself that nothing can go wrong with me! But lo and behold – the next minute my world came crashing down. I could see the concentric growth on the monitor, occluding my descending colon. The subsequent events unfolded at a rapid pace – surgical resection, chemotherapy, and FOLFOX regimen in full swing. As I (and my family members) gradually accepted the reality – my moods went through phases of disbelief, anger, denial, feeling of “why me?” despondency, and ultimately meek submission and acceptance of the inevitable.

No matter how scared or overwhelmed we feel, regarding the emotional trauma and its effect on the psyche, time is a great healer. We adapt to the circumstances and move forward. Probably that is the way it should be.

After two rounds of chemo, since my counts were behaving, my doctor permitted me to attend outpatient department for an hour every day before I turned insane, sitting at home.

As I started talking to patients, I realized how important each complaint was, however, trivial they may seem. I understood nausea, anorexia, fatigue – all these terms. I also realized my folly in ignoring these in many. Now, when I inspect the vascular access, the counter punctures, the minor hematomas, etc., I feel the pain. I realize that this is their life-line; it certainly deserves tender loving care.

While interacting with the dialysis patients, I started realizing the subtle signs of depression. Regarding the non-compliance to the dialysis schedule and the medications/irregular follow-up, I realize that they are related to the emotional disturbances, which we very often overlook. I could see the enthusiasm with which my dialysis medical officer would correct the ultrafiltration rate, calculate the spKt/v, to achieve a “good” dialysis. Little did he analyze about the quality of life (QoL). The medication prescription written very often resembles a mini pharmacopeia. How often have we analyzed their sleep disturbances, social support, and QoL of the care givers? I feel many of us could do better.

As I look back on the day of my surgery, how well the nurses tried to pep me up, as I was wheeled into the theatre, how well they received me in the surgical intensive care unit (ICU) and took care of all the lines with utmost care and concern. Each member of the team excelled in bestowing that little extra tenderness.

Our social worker walked in for a long gossip session. When I enquired how she felt working in Oncology, she came out with a very relevant observation and said “Doctor, the ‘cure rates’ in several malignancies are very good, thanks to the excellent chemo agents and innovations in radiation therapy, so targeted with minimal side effects, that I find it any day better than many other chronic ailments.” How true.

‘Cure rate’ is a phrase unheard of in several departments – including Nephrology. A very buoyant statement from our social worker!!

Friends and well-wishers continued to drop in to give pep talks. Many of them spoke at length about how Lance Armstrong could bounce back after advanced malignancy, to win the Tour de France – a race famed for its grueling intensity, how Steve Jobs could achieve the iPad/iPhone revolution despite his terminal malignancy.

I recollected my days in the bed with the continuous chemotherapy pump that was set for 48 h. I would eagerly look for the oncologist to drop in and reassure me and my family members that all is well. It also made me ponder – how often have I sat down beside the patient and heard him or sat with the family members to tell them about immunosuppresion.

The practicing nephrologist needs to be an all-rounder – physician, well-wisher, psychotherapist, and a good soft-spoken gentleman. Let's recollect our undergraduate teaching that health is defined as not only the absence of disease and infirmity but also the presence of physical, mental, and social well-being. I reckon that our post-graduate training empowers us with lot of skill in tackling disease, life teaches us the rest – how to deal with people.

Life is more accurately measured by the lives that we have touched than by the materials we have acquired.


    Fulltext Views
    55

    PDF downloads
    46
    View/Download PDF
    Download Citations
    BibTeX
    RIS
    Show Sections