As I drove through town yesterday, I noticed the many people that donned many apparel and/or possessed various paraphernalia, to express their support for the annual "Susan G. Komen Race for the cure” event, in remembrance of the lives - and families for that matter - that have been affected by either a diagnosis of cancer or worst still, death caused by cancer. To honor these many lives, some participants ran, others walked, a few others hiked, while others just looked on in support, participating nonetheless.
This event reminded me (and others, I'm sure) of the "cruelty" of cancer and its effects on each and every one of us; A 'simple' diagnosis of any form of cancer comes with it, severe psychological as well as financial burdens, not to mention the persistent pressure of living one's life in fear. Each day, one wonders if they will have the opportunity to experience what the next day, and even the next minute has to offer. I, personally, have seen quite a few lives, affected by this devastating disease; some that were blessed enough to fight through it, while others fought hard as they could, but in the end, were called to home to enjoy the "eternal life" that we all look forward to some day. Many others however, continue to fight hard each day, as they are constantly subjected to all kinds of surgeries, chemotherapies and drugs. Through all of these, they fear, they cry, they give up on themselves sometimes.....but they have learned to hope and look forward to the future in anticipation for the best. When several of them say "I'm ready for this to be over," they mean it! Not only for them, but for their families as well. They realize the constant pressure their state of health has on their families, and are ready to relieve them of such duties. This, again, reminds me of a similar disease that I care about deeply and have personally worked on in research; Alzheimer's disease. We ought to remember that cancer and Alzheimer's disease, unlike other disease states, are not caused as a result of poor behavioral and/or health choices, but rather as a result of cells in our bodies going haywire. These are folks that need not go through this, but until the scientific community is able to resolve this problem, we unfortunately will have to deal with its horrendous effects. (It was for this reason, I decided to offer my little 'two cents' towards Alzheimer's research by completing an undergraduate thesis on the topic. For anyone interested, my thesis documents can be found at https://docs.google.com/open?id=0ByM7ooRXYCySYjY3cnpwODMzXzQ and the more technical https://docs.google.com/open?id=0ByM7ooRXYCySQjZVUFQ1Zk15ZDA )
The “Race for the Cure” event is an amazing way to remember the lives of the many people taken by cancer, but most importantly, it serves to remind us that we as humans aren't perfect in any way and will not be, until we realize the imperfections of our own selves and others, as well as the imperfections of all systems including that of the human body. It is only through this realization that we can unite as a HUMAN RACE; not a race based on place of birth/origin, gender, color of the skin, political affiliation or other socio-economic factors. We are A RACE, dedicated to a common cause, with a collective responsibility to make the world a better place for all that inhabit it. In this unity, we remember the many lives lost to cancer and offer our sincerest condolences to the numerous families suffering from its toll. More importantly however, may we "Race for the Cause” of the Human race.
In love, unity and the remembrance of life,
~ItsWil Son!!!!
PS: Feel free to share, if you so wish.
Sunday, October 21, 2012
Saturday, December 31, 2011
My New Year's message to YOU!!!
To those that relate to the next few words,
I wish to say this without pretense;
I do not care how you got into this world,
I do not care what you are here for,
neither do I care how long you have been here.
What I care most importantly about,
is for you to come to the realization
that this world inflicts upon all of us
some temptation, pain and affliction
However, this is a place to join and network with a wider community,
to put in the best of your effort and ability
and trust me, without hesitation, you will achieve all your expectations
no matter how big or small.
Remember though, that certain people might present themselves as "friends"
But be cautious!!! They are nothing but deceptive, disgraceful and ungrateful allies
who WILL leave you in the midst of your pain and trials
And WILL NEVER return until your predicaments have been resolved
and you have slowly but surely worked yourself back to your succesful past!
Stay away from them, for they add nothing but pain and disgust.
Just a few hours away, lies the beginning of a new year.
I exhort you to make a detailed and careful audit of yourself, then an honest reflection followed by a REALISTIC New Years resolution.
A resolution that hopefully includes taking advantage of every bit of opportunity that presents itself, putting in the best effort possible to be successful in ALL you do, and to learn NOT to give up, no matter what.
In this upcoming year, I wish you the very best of every little thing that you wish for yourself, but I wish above all things, for GOOD HEALTH, LONG LIFE AND PROSPERITY in all of your endeavors.
May we live this day, in continual remembrance of the birth of Christ and its significance to the success of our lives and the BEST OF TIMES.
I wish to you all, a very Happily, blessed New Year!!!!!!!
I wish to say this without pretense;
I do not care how you got into this world,
I do not care what you are here for,
neither do I care how long you have been here.
What I care most importantly about,
is for you to come to the realization
that this world inflicts upon all of us
some temptation, pain and affliction
However, this is a place to join and network with a wider community,
to put in the best of your effort and ability
and trust me, without hesitation, you will achieve all your expectations
no matter how big or small.
Remember though, that certain people might present themselves as "friends"
But be cautious!!! They are nothing but deceptive, disgraceful and ungrateful allies
who WILL leave you in the midst of your pain and trials
And WILL NEVER return until your predicaments have been resolved
and you have slowly but surely worked yourself back to your succesful past!
Stay away from them, for they add nothing but pain and disgust.
Just a few hours away, lies the beginning of a new year.
I exhort you to make a detailed and careful audit of yourself, then an honest reflection followed by a REALISTIC New Years resolution.
A resolution that hopefully includes taking advantage of every bit of opportunity that presents itself, putting in the best effort possible to be successful in ALL you do, and to learn NOT to give up, no matter what.
In this upcoming year, I wish you the very best of every little thing that you wish for yourself, but I wish above all things, for GOOD HEALTH, LONG LIFE AND PROSPERITY in all of your endeavors.
May we live this day, in continual remembrance of the birth of Christ and its significance to the success of our lives and the BEST OF TIMES.
I wish to you all, a very Happily, blessed New Year!!!!!!!
Monday, December 26, 2011
What does it mean to be hopeful? Can I die and yet live??
“Who do we have next,” my preceptor, (we’d call him Dr. F) asked as he finished dictating notes on a patient we had just seen a few moments earlier. As is the norm, I looked through our next patient’s chart and took note of the important details, while Dr. F dictated notes on previous patients. I was supposed to do this in order to have an idea of what problems the patient came to the hospital for, and be ready to answer any questions just in case Dr. F decided to quiz me on anything before going in to see the patient.
“This is (Let’s call him Mr. T)” I started. “Mr. T is a 54 year-old male, presenting with symptoms of lower limb pain and a history of Lower Extremity Arterial Disease. His recent lab report shows a CTA ordered by Dr. M, who is considering a possible above-knee amputation of his left leg. (Side note: A CTA stands for Computerized Tomographic Angiography and is a radiological test that combines the technology of a conventional CT scan with that of traditional angiography to create detailed images of the blood vessels in the body.)
Dr. F then grabbed the chart and asked “anything else we should know?” “Not quite,” I answered. He flipped through the patient’s chart and took out his latest scan results. After going over the detailed report, Dr. F decided to draw out a detailed picture of what exactly the report said, as he always does for all his patients with blood vessels that are occluded. He took out the paper that had a picture of the different arteries and veins found in the abdominal and pelvic regions. We began, as Dr. F marked out the picture with as much detail as possible. “Partial occlusion of right common iliac artery. Complete occlusion of left common iliac artery. Patent left-to-right femoral-femoral bypass. Occlusion of right internal iliac artery. Complete occlusion of left internal iliac artery.” At this point, I thought “we are in for some trouble. This is going to be an interesting patient.” Dr. F continued “occluded left femoral-popliteal bypass, occluded superior and inferior gluteal arteries” and on, and on, and on…..Basically all other blood vessels in our patient’s lower limb were either partially occluded or worst still completely occluded. At this point, Dr. F sighed, and then said “This patient is in bad shape. Let’s go see him.”
As we approached the patient’s room, I imagined a young, at least healthy looking 54 year old man who unfortunately just had to face this unfortunate misfortune of having his leg cut off. To my surprise, as we knocked and entered, I did not see a patient sitting on the hospital bed. I looked around, and there he was, sitting in a wheelchair, by himself, completely covered in thick blanket with nothing but just his legs sticking out. Immediately, I learned my first lesson: EXPECT TO BE DISAPPOINTED!
As he noticed that someone had entered, he slowly uncovered his face. His facial expression could explain how much pain Mr. T was going through. He definitely looked sick; his thin, pale face was covered with an indescriptive expression. One that melted my heart as I thought how obvious it was that he was in so much pain, but was trying very hard to smile back at me. His moustache and beard had outgrown and covered his mouth, and all I could see was his frail-looking eyes which tried very hard to convey his emotions.
After introducing himself and me, Dr. F asked “so who referred you to come see me, Mr. T?” As slowly as he could, I heard our patient talk for the first time. “I do not know, doctor,” he replied in a voice as weak as an almost dying patient, gasping for breath. At this point, my heart missed a beat as numerous questions began to go through my already confused mind. “Does this patient know he’s really sick? Does he know he’s about to lose a leg? Does he know why he’s here? Hell…..does he even know where he is? Does he have a family? Anyone care about him?” As I looked back at him, he carefully and slowly covered himself with his blanket and appeared to have gone back to what seems to be ‘deep sleep.’ Lesson 2 : RELAXXX
Dr. F proceeded to listen to his lungs and heart, checked his temporal, carotid, radial, ulnar and popliteal pulses and then finally sat on a stool to examine our patient’s lower extremeties. Dr. F asked “Are you able to walk any?” Mr. T. J answered “No, doctor.” Both of his legs looked very tiny and small in size, his left leg considerably smaller than the right. This was definitely a classical example of disuse atrophy. When Dr. F asked when the last time was when he last walked, Mr. T answered in what seemed to have been the voice of a toddler “not after my stroke about a year ago.” What???? I thought to myself. He’s had a stroke too?! Lesson 3: ALWAYS read the patient’s past medical history IN DETAIL!!!
Aha!! That explains his physical appearance and his general health condition.
As we proceeded to examine his left leg, I noticed that our patient’s 3rd, 4th and 5th toes were missing. The nails on his remaining 2 toes were discolored, disorganized and looked as though they will fall off if one should exert even very little pressure. His entire foot looked cyanosed, which confirmed his history of lower extremity arterial disease and the extensive occlusions present in his blood vessels that supplied blood to his left leg. In an attempt to further examine his foot, Dr. F tried to raise our patient’s foot, as he moaned and groaned in pain. As I looked back up at his face, I could see the pain and discomfort illuminated in his eyes. “Does anyone care about this poor man? Does his wife not realize his pain? Does she not know that she needed to be here to comfort and provide support to his seriously ill husband? Lesson 4: Before we get married, future wifey must be put to a test to prove beyond reasonable doubt that she will be there for me, no matter what….” #Just saying. :)
By now, we counted up to 5 huge ulcers on Mr. T’s foot. Ulcers that were covered with bandages but were obviously not healing. These ulcers could only be managed and kept clean as nothing else could be done to make them heal due to the poor blood supply to his legs and feet. We redressed his ulcers and the big moment came; discussing options and see what could be done. Mr. T was very sick and obviously in so much pain, Dr. F could not even explain the diagram he had prepared earlier to help him understand his situation better. It was obvious: our patient needed help, no matter what the underlying cause of the disease was.
As Dr. F explained to him what his options were, our patient looked very attentively and seemed to be understanding every single detail. His options? Well, they could continue to watch and manage his leg just like they are now, OR they could amputate the leg above the knee, as it is impossible for the area below the knee to heal if the amputation should be done below the knee. After what seemed to have been 10 long seconds of silence, our patient attempted to talk. He sighed heavily, and then said softly, “I have something to tell you, doctor.” At this point, I realized that Dr. F was ready to do anything, even if it was beyond his means to help this poor man. I could see it in his eyes as he responded “Yes, go ahead and talk to me. I am here for you and take as much time as you need. I will be here waiting patiently.” Lesson 5: TRULY CARING, LOVING AND COMPASSIONATE PHYSICIANS DO EXIST!
Again after a period of long silence, our patient whose breathing appeared to get shallower each second began to speak. While trying to catch as much breath as he possibly could, he said “Doctor” and paused….”I am very confident that I will be able to walk again one day. I know I’ve had a stroke and will possibly not be able to walk again, but I know that I can.” He then paused again, eager to say something next but couldn’t. I could feel the tears build up in my eye, ready to get loose!!! As the pressure continued to build up in the room, he broke the silence again saying “but I know that you are a doctor, and I trust you enough to decide what is right for me.” Our patient just taught and reminded me of this very important virtue and lesson; Lesson 6: NEVER, EVER LOSE HOPE, NO MATTER WHAT!!!!
Even after having been told by numerous people and doctors alike about his inability to ever walk again, this utterly sick patient remained hopeful. He believed that even in the midst of all the problems, his 3 already lost toes, his unrepairable feet and a completely “dead limb,” there was still HOPE that he could potentially be able to walk some day. At this point I could feel the pressure and buildup of sympathy and sadness in the room. I held myself tight, trying my best to not let a tear drop! Lesson 7: HOLD YOURSELF TOGETHER. DO NOT LET YOUR EMOTIONS OVERCOME YOU.
When Dr. F asked our patient if there was any family member or guardian he could call and talk to about the situation, Mr. T answered NO! Although his medical records and chart said he was married, our patient said No?! Wow……Hell, make that lesson 8: BE VERY CAREFUL IN THE WIFEY SELECTION PROCESS. Not all that glitters is gold!!!
Dr. F, looking as dismayed as myself then asked Mr. T if he was married, to which he answered in the affirmative. When Dr. F asked if he could call his wife to ask of her opinion and/or permission to amputate, our patient remained speechless for a while, thought for a few seconds and then said “Okay. Just do what you have to do, in order to help me, doctor.” Clearly, Mr. T had his faith and remained hopeful that his leg could be salvaged. Thus, he wanted to continue to manage his leg, in hopes of being able to walk again someday. Medically, however, there was nothing that could be done to help salvage his leg from further damage. Thus, an amputation above the knee was necessary and the only way to help this patient. Lesson 9: ETHICAL SITUATIONS ABOUND!!
This ‘conflict of interest,’ if you will, especially in the absence of a family member to make a decision on behalf of the patient leaves physicians in this mind and nerve-wracking bout of ethical decision making.
I can only hope that Mr. T’s wife will be willing to help in the decision-making process when she is contacted, as her husband was sent to his rehabilitation home in pain, agony and the unending thoughts that no one, yes absolutely no one cares about him, not even the woman who promised on that fateful day to “have and to hold from this day forward...in sickness and in health, to love and to cherish, till death do us part, according to God's holy ordinance.” Lesson 10: Even when people fail you, remember that LIFE GOES ON…KEEP ON KEEPING ON.
If there’s anything I have learned that I hope to remind myself of and hope to carry with me for as long as I live, it is this. That LIFE is indeed a journey. Expect to be disappointed. But when you do, just RELAX. Keep on keeping on….be hopeful that your present location will NOT determine your future destination. Ask for help when you need it and take on the journey, an inch at a time.
Thank you, Mr. T!!!!
“This is (Let’s call him Mr. T)” I started. “Mr. T is a 54 year-old male, presenting with symptoms of lower limb pain and a history of Lower Extremity Arterial Disease. His recent lab report shows a CTA ordered by Dr. M, who is considering a possible above-knee amputation of his left leg. (Side note: A CTA stands for Computerized Tomographic Angiography and is a radiological test that combines the technology of a conventional CT scan with that of traditional angiography to create detailed images of the blood vessels in the body.)
Dr. F then grabbed the chart and asked “anything else we should know?” “Not quite,” I answered. He flipped through the patient’s chart and took out his latest scan results. After going over the detailed report, Dr. F decided to draw out a detailed picture of what exactly the report said, as he always does for all his patients with blood vessels that are occluded. He took out the paper that had a picture of the different arteries and veins found in the abdominal and pelvic regions. We began, as Dr. F marked out the picture with as much detail as possible. “Partial occlusion of right common iliac artery. Complete occlusion of left common iliac artery. Patent left-to-right femoral-femoral bypass. Occlusion of right internal iliac artery. Complete occlusion of left internal iliac artery.” At this point, I thought “we are in for some trouble. This is going to be an interesting patient.” Dr. F continued “occluded left femoral-popliteal bypass, occluded superior and inferior gluteal arteries” and on, and on, and on…..Basically all other blood vessels in our patient’s lower limb were either partially occluded or worst still completely occluded. At this point, Dr. F sighed, and then said “This patient is in bad shape. Let’s go see him.”
As we approached the patient’s room, I imagined a young, at least healthy looking 54 year old man who unfortunately just had to face this unfortunate misfortune of having his leg cut off. To my surprise, as we knocked and entered, I did not see a patient sitting on the hospital bed. I looked around, and there he was, sitting in a wheelchair, by himself, completely covered in thick blanket with nothing but just his legs sticking out. Immediately, I learned my first lesson: EXPECT TO BE DISAPPOINTED!
As he noticed that someone had entered, he slowly uncovered his face. His facial expression could explain how much pain Mr. T was going through. He definitely looked sick; his thin, pale face was covered with an indescriptive expression. One that melted my heart as I thought how obvious it was that he was in so much pain, but was trying very hard to smile back at me. His moustache and beard had outgrown and covered his mouth, and all I could see was his frail-looking eyes which tried very hard to convey his emotions.
After introducing himself and me, Dr. F asked “so who referred you to come see me, Mr. T?” As slowly as he could, I heard our patient talk for the first time. “I do not know, doctor,” he replied in a voice as weak as an almost dying patient, gasping for breath. At this point, my heart missed a beat as numerous questions began to go through my already confused mind. “Does this patient know he’s really sick? Does he know he’s about to lose a leg? Does he know why he’s here? Hell…..does he even know where he is? Does he have a family? Anyone care about him?” As I looked back at him, he carefully and slowly covered himself with his blanket and appeared to have gone back to what seems to be ‘deep sleep.’ Lesson 2 : RELAXXX
Dr. F proceeded to listen to his lungs and heart, checked his temporal, carotid, radial, ulnar and popliteal pulses and then finally sat on a stool to examine our patient’s lower extremeties. Dr. F asked “Are you able to walk any?” Mr. T. J answered “No, doctor.” Both of his legs looked very tiny and small in size, his left leg considerably smaller than the right. This was definitely a classical example of disuse atrophy. When Dr. F asked when the last time was when he last walked, Mr. T answered in what seemed to have been the voice of a toddler “not after my stroke about a year ago.” What???? I thought to myself. He’s had a stroke too?! Lesson 3: ALWAYS read the patient’s past medical history IN DETAIL!!!
Aha!! That explains his physical appearance and his general health condition.
As we proceeded to examine his left leg, I noticed that our patient’s 3rd, 4th and 5th toes were missing. The nails on his remaining 2 toes were discolored, disorganized and looked as though they will fall off if one should exert even very little pressure. His entire foot looked cyanosed, which confirmed his history of lower extremity arterial disease and the extensive occlusions present in his blood vessels that supplied blood to his left leg. In an attempt to further examine his foot, Dr. F tried to raise our patient’s foot, as he moaned and groaned in pain. As I looked back up at his face, I could see the pain and discomfort illuminated in his eyes. “Does anyone care about this poor man? Does his wife not realize his pain? Does she not know that she needed to be here to comfort and provide support to his seriously ill husband? Lesson 4: Before we get married, future wifey must be put to a test to prove beyond reasonable doubt that she will be there for me, no matter what….” #Just saying. :)
By now, we counted up to 5 huge ulcers on Mr. T’s foot. Ulcers that were covered with bandages but were obviously not healing. These ulcers could only be managed and kept clean as nothing else could be done to make them heal due to the poor blood supply to his legs and feet. We redressed his ulcers and the big moment came; discussing options and see what could be done. Mr. T was very sick and obviously in so much pain, Dr. F could not even explain the diagram he had prepared earlier to help him understand his situation better. It was obvious: our patient needed help, no matter what the underlying cause of the disease was.
As Dr. F explained to him what his options were, our patient looked very attentively and seemed to be understanding every single detail. His options? Well, they could continue to watch and manage his leg just like they are now, OR they could amputate the leg above the knee, as it is impossible for the area below the knee to heal if the amputation should be done below the knee. After what seemed to have been 10 long seconds of silence, our patient attempted to talk. He sighed heavily, and then said softly, “I have something to tell you, doctor.” At this point, I realized that Dr. F was ready to do anything, even if it was beyond his means to help this poor man. I could see it in his eyes as he responded “Yes, go ahead and talk to me. I am here for you and take as much time as you need. I will be here waiting patiently.” Lesson 5: TRULY CARING, LOVING AND COMPASSIONATE PHYSICIANS DO EXIST!
Again after a period of long silence, our patient whose breathing appeared to get shallower each second began to speak. While trying to catch as much breath as he possibly could, he said “Doctor” and paused….”I am very confident that I will be able to walk again one day. I know I’ve had a stroke and will possibly not be able to walk again, but I know that I can.” He then paused again, eager to say something next but couldn’t. I could feel the tears build up in my eye, ready to get loose!!! As the pressure continued to build up in the room, he broke the silence again saying “but I know that you are a doctor, and I trust you enough to decide what is right for me.” Our patient just taught and reminded me of this very important virtue and lesson; Lesson 6: NEVER, EVER LOSE HOPE, NO MATTER WHAT!!!!
Even after having been told by numerous people and doctors alike about his inability to ever walk again, this utterly sick patient remained hopeful. He believed that even in the midst of all the problems, his 3 already lost toes, his unrepairable feet and a completely “dead limb,” there was still HOPE that he could potentially be able to walk some day. At this point I could feel the pressure and buildup of sympathy and sadness in the room. I held myself tight, trying my best to not let a tear drop! Lesson 7: HOLD YOURSELF TOGETHER. DO NOT LET YOUR EMOTIONS OVERCOME YOU.
When Dr. F asked our patient if there was any family member or guardian he could call and talk to about the situation, Mr. T answered NO! Although his medical records and chart said he was married, our patient said No?! Wow……Hell, make that lesson 8: BE VERY CAREFUL IN THE WIFEY SELECTION PROCESS. Not all that glitters is gold!!!
Dr. F, looking as dismayed as myself then asked Mr. T if he was married, to which he answered in the affirmative. When Dr. F asked if he could call his wife to ask of her opinion and/or permission to amputate, our patient remained speechless for a while, thought for a few seconds and then said “Okay. Just do what you have to do, in order to help me, doctor.” Clearly, Mr. T had his faith and remained hopeful that his leg could be salvaged. Thus, he wanted to continue to manage his leg, in hopes of being able to walk again someday. Medically, however, there was nothing that could be done to help salvage his leg from further damage. Thus, an amputation above the knee was necessary and the only way to help this patient. Lesson 9: ETHICAL SITUATIONS ABOUND!!
This ‘conflict of interest,’ if you will, especially in the absence of a family member to make a decision on behalf of the patient leaves physicians in this mind and nerve-wracking bout of ethical decision making.
I can only hope that Mr. T’s wife will be willing to help in the decision-making process when she is contacted, as her husband was sent to his rehabilitation home in pain, agony and the unending thoughts that no one, yes absolutely no one cares about him, not even the woman who promised on that fateful day to “have and to hold from this day forward...in sickness and in health, to love and to cherish, till death do us part, according to God's holy ordinance.” Lesson 10: Even when people fail you, remember that LIFE GOES ON…KEEP ON KEEPING ON.
If there’s anything I have learned that I hope to remind myself of and hope to carry with me for as long as I live, it is this. That LIFE is indeed a journey. Expect to be disappointed. But when you do, just RELAX. Keep on keeping on….be hopeful that your present location will NOT determine your future destination. Ask for help when you need it and take on the journey, an inch at a time.
Thank you, Mr. T!!!!
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