Wednesday, August 16, 2006

It goes on

In three words I can sum up everything I've learnt about life: It goes on.
Robert Frost

I am still enjoying haematology. It’s interesting – clinically and scientifically, the team of doctors I’m with are lovely, and there’s time to get to know the patients. But the most important thing I’m learning? The utter persistence of life, and the resilience of the human spirit.

At the multidisciplinary meeting this week, a patient’s karyotype (basically sorting the chromosomes into their pairs and seeing if they are all present and correct) was displayed on the main screen, to illustrate the presence of multiple chromosome disruption. It was amazing: he had deletions, repetitions, translocations, funny little stunted things that surely can’t be functioning. His karyotype was a complete and utter mess. I personally couldn’t understand how any of his cells were still alive. And yet this guy only has chronic myeloid leukaemia (CML). I say only, it’s no picnic of a diagnosis, but I was gobsmacked. Life is so extraordinarily good at surviving, at continuing in the face of apparent hopelessness.

Many haematology patients are dying. They have leukaemias that are refractory to treatment, or they relapse after treatment, or treatment for an earlier cancer gives them leukaemia. But they keep smiling. The patients I have met on this block have been some of the brightest and chattiest. It makes me want to drag those grumpy rude GP patients who only have a runny nose to clinic and show them: ‘There, you see – this person is DYING, and they are pleasant and friendly and enjoying life. You only have a frickin’ runny nose! Go away and STOP WASTING MY TIME.'

Not sure that’s ethically or professionally allowable.

That said, maybe having a life-limiting condition does actually make you a better person. When I was a wee thing, I sang in a church choir with a woman who was incredibly sour and miserable. She was rude and difficult, and I was terrified of her. But after receiving a diagnosis of terminal lung cancer she became a different woman. Pleasant, helpful, she even smiled. It's as if having a sell-by-date stamped on her made her see that there just isnt enough time to be rude. Life is so short; why waste it on being a horrible person? I think having a terminal illness makes you want to be the best version of yourself that you can, to lose all the anger and unhappiness, and see the best in life for the remaining time you have.

After all, who wants to be remembered for being a miserable bugger?

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