"Your reason and your passion are the rudder and the sails of your seafaring soul." - Kahlil Gibran

Wednesday 28 March 2012

Getting back my mojo

The Urban Dictionary defines one's mojo as your sense of purpose and meaning in life. Your mojo is your personal energy and charisma, your cool or style essence. Mojo is that little bit of majic that sets you apart from everyone else. Its that sparkle, the passion that makes each person totally awesome in their own unique way.
Sounds just epic to me! Wonder where I could buy me a bit of that stuff. I never knew I had me a little mojo until there was a void where my mojo used to be. I had regressed to a place where I hated my job. It had become monotonous and frustrating and didn't stimulate me as it used to do. Despite that, my personal life was being neglected as I was spending all my time at work. I was stuck in a rut.
Now, I refer you back to my very first post on this blog. Its all about a stab heart. I just LOVE stab heart cases! I don't mean that in the figurative sense but actual knife-through-the-heart surgical cases. I do say this with the utmost respect to the patient involved. To be so close to the physical life force keeping a body pulsing, and to really see the fragility of life in such a dramatic way, can only jolt one's mojo back into your own personhood.
The specific patient I refer to was rushed into casualties by highly charged ambulance men, very aware of the urgency of the situation. A jagged 10cm long wound cut across his left precordium. Blood bubbled out in gusts with every gasp he took. I explored the wound with my finger. Under the sharp edge of his fractured rib, I could clearly feel his, already weak heart beating. After rapid resus efforts we rushed him to theater; sawed open his chest; stopped the bleeding; and with God 's grace, granted him another chance at life.
The adrenaline and, I guess, the sense of achievement jolted life back into me too.
As we pushed the patient into theater, he stopped me. With effort, he whispered, "Doctor, do your best." I was truelly moved. I don't only have the responsibility towards myself to be connected to my job and my life but other people depend on me to pour my energy and passion into being the best doctor and surgeon I can be.



Saturday 17 March 2012

Entitlement


The current economic environment and pricey private medical care has lead to many previously advantaged people now having to rely on state medical facilities. A state-employed doctor's worst nightmare patient nowadays is no longer the drunk, verbally abusive guy dumped at casualties by a police pick-up van with a couple of stab wounds in the chest and as many scars from previous drunken brawls who vomits stale papsak wine on you. Recent times have created a much more feared patient: the PANDA ( Previously Advantaged Now Disadvantaged ). This is the white lady with the manicured nails and beehive who can no longer afford her private GP's fees so has to submit to state provided medical care. She always arrives at hospital with an entourage: the highly-strung husband who feels like a utter failure for having to bring his pretty wife to a state facility where she is forced to sit in the same queues as her garden boy and domestic worker. Instead ofverbalising his feelings to his wife, he has become moody, added 20 kg to his midrif and has been banned from attending family get togethers following a certain incident concerning his brother-in-law, CEO of a successful company, and a black eye. Also in tow is the bored teen who would rather be slouched in front of his play station but couldn't be left home alone after his mother discovered a little packet containing an unidentified white powder in his sock drawer. And of course, the concerned granny, because the patient needs some form of support and the husband and son clearly don't fit the bill.

So here's the scenario: casualties is busy, as per usual. There are long queues of patients to be seen. The folders are stacked high. As per protocol patients are classified as red, orange or green. Red meaning they are seriously ill and often in mortal peril. Obviously those are seen first. Green patients have non life-threatening complaints and stable vital signs. You are rushing about trying to sort out your patients as best and as fast as you can when a very agitated PANDA husband comes up to you, "Excuse me, girly,  when will my wife be seen?" 
"I am Dr Guinevere, Mr Panda. Have you opened a folder yet?"
"We arrived before the man you've just been examining, and my wife is tired, and I have to be at work in the morning. We can't wait any longer."
You look to where the man is gesturing and quickly spot the only white patients in the waiting room. Sure, the wife looks tired, the son morose, the gran is apparently admonishing the young girl with babe in arms beside her for her teen pregnancy.
"I'm sorry you're having to wait, Sir. I had to see the gentleman who arrived after you, first because he is very seriously injured was about to die. You might have seen the paramedics bring him in on a spinal board with head blocks, noticed the endotrachial tube in his throat and the nurse giving him oxygen via a face mask. Perhaps you also saw that his leg had been severed just above the knee, was oozing blood in a steadily weakening stream as his blood pressure was falling and his heart quickly weakening, on the brink of asystole. I had to help him as a matter of emergency, you do understand, Sir."  Mr Panda goes to sit down and is placated for a full 5 minutes. Or is it perhaps queasiness with the mildest green tinge you spy round his mouth? Wife and gran give hubby a look that says so clearly they both think he's an absolute loser for not being able to afford the luxuries of the Mediclinic waiting room. Not 10 minutes later, Mrs Panda stands before you.  Mascara slightly smeared  and lips too pale but still poised on high heels, she holds on to granny's arthritic hand for support. The sullen teen has obviously been told to get up and help his mother but he drags behind, dying from embarassment behind his greasy fringe. Just as your eye catches Mrs Panda's, she starts moaning bitterly and grabs hold of  her abdomen, bending over double. 
"Dear Mrs Panda, won't you sit down before you hurt yourself. I'll ask the nurse to give you something for the pain." 
"I don't want an injection, I want the doctor to see me." She drops the charade and hands you her cellphone. "Here, speak to Mrs de Klerk, she's the dominee's wife you know, and her son-in-law is an orthopaedic surgeon in Australia. She'll be able to tell you how serious my condition is and that I am to be seen right away. And do remember that I can't have penicillin or voltaren because of my delicate constitution."
"I am sorry for the delay Mrs Panda, kindly sit down and await your turn. Everyone in this casualty is ill and will be attended to." You hand her telephone back to her and indicate the full waiting room. There is a dehydrated baby with sunken eyes you know you'll have to attend to quickly. An old man is coughing up blood. He has either TB or a lung tumour. A mom is comforting her toddler who has a rash that looks suspiciously like measles. Next to her is a man covered in bloody crusts from a wound to his scalp.

 I wouldn't very much like to wait hours on end in this waiting room full of unpleasant smells and infectious diseases. Some of us have experienced air conditioned waiting rooms with old editions of Fair Lady and Weg to page through. Others have never had this luxury. No matter how uncomfortable a state hospital's  casualty set-up is, all the South African hospitals I've worked at have provided care of a very high and academic standard to their communities. With the advent of the NHI ( National Health Insurance ), patients from the extremes of social backgrounds will be thrown together more often. It will make for a very interesting study in social adaptation and human tolerance. Whether South Africa is ready for such a dramatic amalgamation of the classes I find doubtful. 

Mrs Panda, glances over her shoulder, in a soft voice, discreetly, she says to  you, "Ag, kom nou, Sussie, jy's mos een van ons. Sit nou die Tannie se leer bo-op die hoop dat ons volgende gesien kan word."

Saturday 10 March 2012

I will survive!

What makes a person survive stressful life events? Over the last, say two months, I have collected a crippling burden of stressful events. I share these with you not to invite pity but to illustrate humanity's caring nature and the endurance of man's will to survive. My life crises come nothing close to what we know many individuals to be faced with in war and famine and natural disaster situations. I don't claim that my lot is at all comparable, only to recognise that each person's little problem is huge to them, as it affects their daily life and future plans.

So, within the past two months I have endured the death of a close family member; the break-up of a romantic relationship; I moved towns and provinces meaning that I've had to make new friends and get to know new colleagues; moved to a new job with much more responsibility and strenuous working hours; become a student again and faced majorc career choice questions; survived a financial crisis; faced possible eviction; had a tumultuous emotion-laden Christmas and holiday season including unpleasant in-law encounters and a major change in social life and circumstances.

The Life Event Stress Scale ranks a number of stressful life events according to their likelihood of leading to stress-related illness. I tipped the scales well over the 350 mark with my recent collection of stressors. So I am well warned of having a 'high susceptibility to stress-related illness'. (You'd be glad to know I'm taking my vitamin Cs religiously.) I have included a link to the above mentioned scale at the end of this blog.

The question is thus, how do we carry on when our dreams are shattered, when our foundations are crumbling underneath us, when there seems to be no hope left in the world? Drink and drugs are always an option. Make of this what you will. Life has to go on and even though we cannot face doing much other than sticking our heads in the sand and pray for time to mend our worlds, responsibilities can be shirked only for as long as our colleagues and friends will pick up the slack. Even before we can imagine doing so, life forces us to start anew and just get on with it. I'm still waiting to catch up with my life that has seemingly continued around me, without me.

The point I want to get to is that there was love and hope to be found in the most unexpected places when I most needed it. Let me illustrate: not knowing a single soul in a new town especially during a time when I needed my friends and family around me was extremely daunting. I felt very much alone, left out in the cold to wither and wilt in my own hopeless, lightless hole of self-pity. The first ray of light strove to break through when I discovered a beautiful arrangement of wild flowers from my garden on my kitchen counter. My new maid, whom I'd met only once or twice had heard about the passing of my loved one and did something truelly thoughtful and kind for me. It touched my my heart deeply. The second blessing came in the form of a plate full of delicious, steaming, home-cooked food delivered to my front door by darling neighbours. Their timing was just right. I had nothing appetising in the fridge, it had been an especially long day at work and I was seriously considering having Kellogg's for supper. Theyd didn't know me but for having shared a coffee over the fence; I was hardly going to have a heart-to-heart with my brand new neighbours but they showed such care and support in a very practical way, it brought me to tears. I felt more part of my new community than living there for ten years would have done.

Then there is the ex-landlady left behind in Cape Town two years ago who shows me pure, unselfish support. She regularly phoned or emailed me over the past few weeks just to pray for me or share a few words of strength and guidance. When I was too overcome with grief to answer much in return, she understood and never allowed her support and kindness to wane. Her messages always arrive at the most applicable moments - when I'm on call at work and in need of divine strength or home alone and needing a pick-me-upper. I cannot neglect to mention my family, especially my mom and aunt, who despite having to face their own tremendous sorrow, have carried me through the very bleakest of moments, completely neglecting their own well-being in order to see to mine. There is no greater love than that.

Even though the road is wrought with pot holes and all sorts of miserable, nasty things, there remains a beautiful side to human nature. Love and kindness are alive in this world. Thank you to my angels for showing that you care.