Matters of Life and Death

It was past 10 O’clock at night.

My senior colleague and I had been on our feet since 8am that particular Sunday. We had to ignore hints of fatigue and muster all our energy and concentration in an attempt to preserve the life of a critically ill patient in the Intensive Care Unit.

Consultant surgeons were at hand to perform a rare feat – a major surgical procedure in the relatively unsterile conditions of ICU with minimal anaesthesia. This was our last attempt to bring the patient back from the brink of death. The ICU was buzzing with activity, in preparation and anticipation of a real life drama gradually unfolding.

“Er, excuse me doctor, there’s a film crew outside asking for permission to film a scene.”

My senior colleague and I looked at each other in utter disbelief.

“They are filming the drama ‘ABC’ starred by that famous actor YYY!”

The nurse was clearly excited that her idol was standing just beyond the door. I hadn’t a clue what TV programme she was talking about or who the actor was. Needless to say, we were too busy to entertain such a request and proceeded to focus on our task instead.

Hours later, our patient was stabilized and adrenaline levels had returned to normal. As I sat down to review other patients, a man popped through the ICU doors. I noted his dyed hair, funky spectacles and multiple ear studs and immediately assumed he was part of the film crew. He smilingly returned a few things borrowed from ICU, thanked me, and left quickly.

How frivolous it seemed. On one hand we were struggling to keep not just one, but several patients alive. Ours was an ongoing drama with real consequences. Beyond the doors a team of artistes were creating an artificial world of suspense and romance, promising their viewers an hour of non-stop entertainment on prime time television, week after week.

Hospital dramas have long been a popular genre – just think of ER and Chicago Hope. These productions have been so influential in forming public conception of hospitals and the medical profession that I was a little disappointed to discover, early in my career, the REAL world of medicine – long hard hours, often routine and mundane work injected with unexpected moments of exciting action.

My hospital is located at the heart of “cowboy town”, a place rife with gangster activities, with drivers who manouever their little Kancils through town as though it was an F1 circuit. We see many cases of trauma – bullet wounds, parang slashes, amputated limbs, severe road traffic injuries, severe industrial accidents and burns/explosive injuries. Death, in many cases, is inevitable and real.

I remember a teenage boy whose mother seemed unnaturally calm seeing him hooked up to a ventilator and multiple drips. It was his third road traffic accident and he had recovered from the last two accidents sufficiently to get involved in a third. His mother must have expected the medical staff to perform yet another miracle. Unfortunately he succumbed to his injuries.

At the other end of the spectrum are medical situations where death is inevitable, but through no man-made cause. Not too long ago I was attending an emergency Caesarian birth where I assisted the neonatal team in resuscitating the little infant. Feeling happy that I had done a significant ‘good’ for the baby and her mother, I was crushed to find out later in the day that the little child had passed away in ICU due to a fatal congenital birth defect.

It is humbling to know the limitations of Medicine, but it leaves me feeling a little helpless. Each time a Caesar baby emerges, I think of Hannah and the miracle of life she is. I remember the time when we feared she would have to fight for her life if born prematurely, and thank God over and over again. Although Hannah is growing robustly, I am all too conscious of the fact that as parents, Chris and I are mere stewards of this precious gift of God.

Only God has the key to life and death.