Death is not our enemy. Indifference is our enemy. You treat an illness; you will either succeed or fail. But if you treat an individual, I can assure you, whatever be the outcome, you will be successful.
In the Bible the raising of Lazarus is recorded in John’s Gospel chapter 11. A good portion of the chapter is set apart for the details of the incident. Jesus calls out, “Lazarus, come out” (John 11: 43). Jesus calls him by name. In order that Lazarus be raised to life it was necessary, he was called by name. Without a personal reference it may be rather difficult that someone is healed or brought back to life.
I remember reading somewhere that if Jesus had just said “come out” without mentioning the name Lazarus, all the dead in the locality would have come out of their tombs. Establishing a personal relationship is of so much importance.
As we learn, Jesus, the greatest healer, has called everyone by name whom he made his disciples, whom he healed, and whom he raised to life. Establishing a personal relationship by healthcare personnel will certainly enhance the healing, both physical and mental. In this regard Jesus is the best model for doctors and nurses. The success of a doctor depends on how he views his patients, either as a person like himself or as a mere sample for investigation.
One who occupies the doctor’s position today could turn out to be a patient next day because in this world we humans are all created as a combinations of flesh and blood; and when the soul is separated, the rest will be absorbed into the earth. There’s nothing to be boast about.
To the question what could be the best behaviour expected by a patient from his/her doctor, different answers might be given; but the best answer would be that the doctor has to be kind and compassionate. Nowadays there may be people who think that the currency has usurped the place of kindness and compassion in the medical field. On the other hand if the doctors offer care and compassion along with the medicine there might occur more miracles.
The hero in the movie Patch Adems, was a medical student. Later, he becomes a doctor; a beautiful model for a doctor with real care and concern. There is a scene in the movie where the medical students together with their professor attend a bedridden patient. The professor goes through the patient’s medical reports, and explains to the students the illness, the kind of treatment given and the medicines to be administered. Here the patient becomes a mere sample for investigation and treatment. Things like this happen even today.
One day, the professor and the medical students are on a visit to the patients. Adams was also there among the students. They went to visit a bedridden woman. Without even looking at the face of the patient or greeting her, the Professor started to instruct the students:
“This is a case of acute diabetics and her condition is rather serious.”
Then he points to the wounds developing on her feet and continues:
“The wounds you see may develop into other stages of the illness.”
The lady, the patient has been listening to all these with a sad surprise. The Professor, without paying any attention to the patient’s reaction, proceeds to ask the students whether they have any question or doubts and the students are given some time.
One student comes forward with the question:
“What’s the treatment for this?”
“Sugar in the blood has to be brought under control. Antibiotics might be helpful to a certain extent. Most probably amputation of the leg might be required,” the Professor clarified.
That’s the kind of treatment! With least concern for the bedridden patient, without uttering a word to her about her illness or treatment, the Professor speaks only to the medical students!
It must have been a big shock for the patient that her leg might be amputated. Her sorrow and fright dampened her spirit. Under the blanket, out of fear she has been holding her both fists tight.
At the moment there comes a hopeful question from one of the students:
“What’s the name of the patient?”
Quite unexpected question! The professor and the students turn to the questioner with a surprise. The question was from Patch Adems. Convinced that his query was quiet reasonable Adems looked at the professor and repeated the request:
“I would like to know the name of that patient.”
The professor appeared to be a bit disturbed. Only then he remembered that the name of the patient is there in the file which is in his hand. He felt bad that he had payed least care and attention to the person. Ashamed a little and searching in the file, in a low voice, he called out the name:
“Margery.”
Patch Adems, after having thanked the professor, with a smile on his face calls the patient:
“Hai Margery.”
Through that gesture he was actually saying:
“Hello Margery, how are you?”
Suddenly her face bloomed bright; she responded through her smile. This movie, in fact, is an attempt to convince those who are involved in the health care sector that their kind and compassionate approach to the patients would make big difference. Patch Adams strives to follow the principle that the patients are to be offered joy and happiness along with the medicines. He proves that his approach has been very successful with all kinds of patients, even with the terminally ill children and also with those who are depressed for being very close to death.
In between, those who argue that the doctors should keep a distance from their patients try their best to debar Patch Adams from continuing his study of medicine. At the end, he even had to appear before the medical board to obtain his licences for practising medicine. On the occasion he made a very touching speech which everyone in the health care service should listen to.
“The motto of a doctor or any human in general should not be to simply delay the death of the patient, but to increase the person’s quality of life.”
He adds:
“Death is not our enemy. Indifference is our actual enemy. If you treat an illness you may either succeed or fail. But if you treat an individual, I assure you, whatever be the outcome, and you will be successful.”
I am of the opinion that one who thinks that the patients in front of him do not have special connection with him and just prescribes or gives medicine, will only speed up their death. Belief in the one who treats the patients is as important as our faith in God.
In the context of my own sister’s illness I had to come in contact with a good number of doctors. At the time from the main block of the Caritas Hospital, Kottayam, we were directed to meet Dr. Jojo Joseph Vattappallil, of the Oncology Department, Sr. Jessy was almost sure that her illness was cancer. Although the distance to the Oncology Department was very short, Sr. Jessy said later that she felt the walk years long.
Dr. Jojo, the Surgeon in the Oncology Department, happened to be a classmate of Sr. Jessy at school, where our father was also a teacher. These were all very consoling factors. Mr. K.A. George, our father, had been a teacher for 35 years and has several thousands of students in different parts of the world. Dr. Jojo was one among them and it was he who conducted the surgery on Sr. Jessy and confirmed that her illness was cancer. As a classmate and a person from the same locality, Dr. Jojo had special care and concern for Sr. Jessy.
After the surgery, the follow up treatment was under the leadership of the famous cancer specialist Dr. V.P. Gangadharan. Being taken care of by a famous specialist was very consoling. His dealings were very warm and hearty. Sr. Jessy had read a number of books written by him. Whenever she went for consultation with the doctor they would refer to those books too.
“Sister, for a cure from your illness you will have to take six injections,” Dr. Gangadharan said to Sr. Jessy.
He was so careful that he didn’t even use the word chemo. The first cycle of chemotherapy was under his guidance. Later when Dr. Gangadharan limited his visits to Caritas Hospital for health reasons, Dr. Amos, who was with him, had to follow up treatment.
Sr. Jessy hoped that she would be completely cured after the first cycle of chemotherapy. At regular intervals she was to have a check-up and visits to the doctor with the results. Blood results were normal. But life need not necessarily be the same always as we desire or hope for. One time a significant variation was noticed. I accompanied Sr. Jessy for her next visit to Dr. Amos.
He said:
“There isn’t much problem; a few more injections might be needed.”
With a smile she listened to the doctor’s suggestion. But I could see her eyes getting wet. Then came the words of encouragement from the doctor:
“Sister, take courage; if you’re ready I shall make arrangements for the follow up treatment today itself.”
Sr. Jessy turned her eyes to me. As a positive sign I shook my head. Immediately she replied to the doctor:
“Anyhow we are to have it; hence let’s start it today itself.”
After having said thanks to the doctor, we were almost out of the room, and the doctor called me back. He signalled me to be seated. By the time Sr. Jessy and her companion nun were already out of the room. After making sure that they have gone, Dr. Amos started to say:
“Her illness has recurred; a few lucky ones are fully healed with first cycle of chemo; but for others the illness may recur; it’s a bit problematic. Chemotherapy can be repeated; still there’s possibility of recurring the illness.”
At the moment I remembered what Dr. Gangadharan had said when I visited him in his home at Thripunithura:
“Sister’s illness is in the C grade of the third stage; one cycle of chemo can cure her fully; but if the illness recur after the chemo, please keep in mind that it may not be a good signal. The treatment will have to be repeated; and the life of the patient can be extended only for three or four years.”
With that in my mind I asked Dr. Amos:
“Will the next cycle of chemotherapy cure her fully? Will it recur again?”
“It may recur.”
The doctor responded in a lowton, and continued:
“If the illness recurs the treatment will have to be repeated; there’s no other remedy; go on repeating the treatment.”
From that I understood that the treatment will have to be continued forever! With an unpleasant smile I thanked the doctor and left the room.
As I came out of the doctor’s room Sr. Jessy and her companion were waiting for me. With a bit of anxiety they asked me:
“What did the doctor say?”
“Nothing special.”
I tried to evade them. When they insisted upon I told them:
“The next cycle of chemotherapy won’t have the side effects the previous one had, and it would be more effective for a complete healing, according to the doctor.”
From Sr. Jessy’s eyes I could read that my answer was not very convincing to her. Later on several occasions she would ask me:
“What did the doctor tell you that day?”
I would repeat the same answer. Both of us knew well that I was lying to her. My only wish was that if the hope in her mind was similar to the tender leaves on a tree, let them stay on without fading.
After Dr. Amos the treatment was continued under Dr. Unni S. Pillai. He would take more time and explain things in detail. Next cycle of chemotherapy was administered by him. The last one was palliative chemo, and it was done under the direction of Dr. Manu John from the Pain and Palliative Care Department.
Sr. Jessy underwent treatment for three years and nine months, and the above mentioned were the main doctors involved. Every one of them were very compassionate and kind to her. During the period we came across quite a number of nurses who were very helpful and well behaving in their words and dealings. Hearty thanks to everyone in the Oncology Department of Caritas Hospital, Kottayam.
Today, Sr. Jessy is not with us. There is one thing that I have not revealed to her, although she had insisted upon it several times: what the doctor told me on that day.
On the Day of Judgement before God Sr. Jessy with a smiling face might tell me:
“Although you did not reveal it to me on that day, I knew what the doctor had told you.”
Then I too will tell with the same smiling face:
“I also knew that Jessy had understood it that moment itself.”
Fr. G. Kadooparayil MCBSÂ