Lessons from surgery

So I've survived two weeks in general surgery at the VA in Detroit. and its been hard. Its been hard getting up so early, eating suhoor in the car, and trying to find time to squeeze in praying fajr between seeing patients, rounds and lecture. Its been hard on my little feet to be on them all day (orthotic inserts have helped!). its been hard being alert and auto-pilot, answering questions and acting interested for more than 12 hrs a day. But I've learned quite a few lessons in the past two weeks, most of which i havent read in any book.

- Listen.
As one patient who recently had a radical mastectomy and carried around a pump like contraption for over 6 months to promote healing told me: "I know my body." Patients know their bodies, and there is nothing more frustrating for them having someone who they've known for less than 5 mins ignore concerns, fears and doubts. In the interest of time, so many docs write orders for the drugs and treatments they are familiar with, cutting the conversations short and hurrying the patient along so the next one can fill that room. These days, caring for patients is more of a business venture with the intruding rules of insurance companies. Still, as so many patients have taught me, we have to remember that the sick are human beings that are often on an emotional roller coaster. They are entitled to participating in their own health care - even if that means taking a few more moments to listen and collaborate.

- Be thankful.
I saw this patient on Friday who came in with rectal bleeding for 5 months. He had a bad case of the 'rhoids, but more than that, a bloody mass in his anus. When we got the pathology report back, it was positive for adenocarcinoma - cancer. I was there when the resident attempted to tell him what we just found. Thankfully, this type of cancer, depending on how much its spread, is very curable with radiation and chemo. what I could not get over however, was how painful it must have been to have a normal bowel movement with such a mass impeding normal passage. the patient said he had been passing blood for months. He said he dreaded having a bowel movement bc it hurt so damn much. I believed him. For all the jokes we make about this stuff, we should be sooo thankful that we don't think twice about going to the bathroom. Other patients I have seen have had their colon removed for whatever reason and now have the remaining intestinal tract attached to their abdominal wall - and their excretions collecting in a bag attached to the skin. Can you imagine what it must be like to go through that - day in and day out? These are normal ppl that once did normal things including share intimate moments with a loved one. Imagine being a loved one and changing that bag day in and day out. Again, I am so thankful I am healthy and normal! alhumdulilah. At the same time, the strength that emanates from these individuals is amazing. Their patience, faith and attitude is inspiring to say the least.

- The little things count.
On my second night on call, I interviewed a patient who came in with unexplained bleeding. An 80 year old man who'd just lost his wife only 14 months before, his calmness and cheerful disposition amazed me. He was seriously one of the sweetest old men I'd ever met. He talked to me about his childhood, migrating to the US from Greece at age 6, growing up by the Ambassador bridge in Detroit, his high school days and his 50 year marriage with his beloved wife. What struck me the most was his repeated appreciation he had for his new Lebanese neighbors. For the past month, since they had moved there, this Muslim family had been sending him a tray of freshly cooked food every single day. For this old man who lived by himself, this gesture of goodwill was incomprehensible. I smiled to myself when I found out this family was Muslim - what a beautiful good deed and embodiment of all things sincere, gentle and kind in the Quran and hadith's teachings. This was dawah and kindness at its peak, and this old man would never forget the generousness of these beautiful friends.

- Everyone's allowed to cry.
My first night on call I was checking up on patients before calling it a night. I checked up on one patient who had had a simple surgery hours before. A big, burly man with a long white beard and a deep voice, we made small talk for some time. He was here all the way from Toledo and no one from his family or friends was there to keep him company. As we talked more, suddenly I struck a chord and he talked about how distraught he was that he could not work after having three toes amputated a few months before. Now a slave in his own home, in a vicious cycle of despair and isolation, he was utterly depressed. I watched as this huge man, a symbol of what our society deems as physical strength and brawn, broke down when speaking of his mothers death a year before. The tears flowed from his eyes as he tried to gather control of himself. I could not promise him that life would get better, but I offered practical advice which must have sounded so silly coming from a young, naive and sheltered girl. In the end, I just listened.. This burly man had a sensitive, warm heart that was hurting. Everyone's allowed to have a good cry once in a while.

- Touch.
As a Muslim woman, I frequently get bombarded with advice on how I must conduct myself, what I should refrain from, how I should act and what I should do. I've gotten into the whole shaking hands debate - conjecture on the proper response to an innocent gesture of greeting and goodwill. Handshaking aside, I've learned how vulnerable a sick individual really is as he or she lies in that hospital bed, hour after hour. I've realized why there's such an emphasis in Islam placed on visiting, caring, and honoring the sick. I've seen countless patients who spend days between visits from their loved ones, and some receive not one visitor from the outside world. Ive seen people at the peak of vulnerability, as they discover how their bodies have abandoned them and are now privy to the most devastating news they will ever receive in their lives. Its at these times where the warmth and love of holding ones hand is so important. Sometimes, I'm not sure if someone will want to be touched. But just as i think this, I am surprised that they squeeze my hand back, as if holding onto the one last thing that makes sense in their lives. I'm not sure if such gestures are proper for a Muslim woman - but I also know that God is Merciful and that caring for the sick is one of the most honorable deeds in His eyes. Somehow, I think its ok, and I feel closer to Him through my interactions with His creation.

I'm thankful that, with the help of wonderful patients, I've discovered these important lessons early in my career. I feel like i finally appreciate the importance and beauty of the field of medicine, after years of wondering why the hell i was sacrificing a social life, sleep and real income. I can only pray that I remember these lessons no matter how old, jaded or tired I get.