Hello people!
Another written moment of life to be shared, can I?
I have had 7 sessions with them. They called me Teacher
Dayah, I called them my friends. I knew some but not all of them. Not all are
approachable, some are just in pain and some just need their own space. You
need to respect them because they are not at a place where they or even we would
like to be at.
I was talking about those kids in paediatric ward 2A. It’s
an oncology ward. Most of them are at the late stage of different types of
cancer (Leukemia, osteosarcoma, etc.) seeking treatment for comfort. They are
all bald, thin, wheelchair-bound or walking with walking aid around, bruises
over their body, but they all still have a wide smile on their face to greet
you.
Initially, I was quite scared to talk a lot with them because
I have this thought that the kids could be quite fragile. I was so scared that
I would end up talking about matters that were sensitive to them. So, I just
talk about cartoons and teaching things, no personal conversations. My main
role there was to guide them and teach them what they should know according to
their age as most of them have stopped going to school since a few years back.
So, they are quite left out. Thus, I need to teach them to read, write and
count. It’s a good thing to do and at least, they are not bored. Most of the
kids in the ward has been hospitalised for quite sometimes and need a long-term
monitoring. So far, for the 7 sessions, none of my patients have been
discharged yet.
Despite of me avoiding the personal conversations with them,
they are the one who initiate the conversations about their life, their
feelings and their experiences. It was as if they need someone to turn and talk
to but not their parents. They seemed to me as if they want to look good,
healthy and happy only in front of their parents and they don’t want to burden
their parents anymore.
These kids are all matured with a good attitude but
sometimes they throw tantrum too when they were told to take medications or do
physiotherapy that cause them pain. Kids being kids right? However, they know
their responsibility. When the nurses asked them about their vitals sign, they
can do all by themselves. They are well trained that they put and read the BP
machine, thermometer all by themselves. At the age of 10 years old, they are
already reliable to write and record the input and output throughout the day.
They know the amount of water they need to drink in a day so when the doctors
are doing round, they, without their parents at the side, would tell themselves
how much water they have drank throughout the day saying an exact amount in mL.
One of my patient or shall I say student, also
know that she needs to have physiotherapy once daily. In the ward, the
physiotherapist only come once in a while when there’s new patient. So I learnt
that in this hospital/ward, the HOs have to do all the plan from A to Z
including their patients daily physiotherapy. The physiotherapist would teach
the HOs once so they should know what to do. This girl kept reminding the busy
HO to do the exercise for her. She knows the responsibility and she knows what
needs to be done, needs to be done, despite pain that she had during physiotherapy.
As I was there, the doctors in charge of the ward know that I am a doctor too waiting
for my placement (I even follow the afternoon rounds with the Peads team), so
they allowed me to do some of the things and thus, I helped them to do
physiotherapy for some of the patients after learning from them.
It’s impressive for me. A 10 years old girl, without parents
or any guardian by their side, know how to function by themselves. No wonder
the doctors love them so much.
Not just that, imagine an 8 years old boy, asking you what
do you want in life? I was so stunned that I have to mirror the question back
to him without giving my answer first. He is a leukaemia patient. “Can I have
my old life back? I want to play around but mummy won’t allow me play with my
friends. I look so weird too, I have got no hair so those kids beside my house
are scared with me.” How do I answer a young boy who wanted his normal life
back? Be grateful for your life now? Be strong, you’re going to be okay? I have
to shift the topic away because I don’t want to disappoint him with a wrong
answer. And sometimes, he would tell me that he saw his parents crying at
night. He asked, “Am I the cause? Aren’t they tired taking care of me,
Teacher?”. When I asked him, “What do you want me to bring for you tomorrow?”.
He answered me once, “I want you to heal me, can you?” And then he laughed. I
don’t know whether I should laugh together, whether that was a joke he was
saying to me or whether that was some sort of serious conversations. I at all
did not imagine having an 8 years old boy asking all these questions to me. But
sometimes, I talk to them, answer them and be their friend. Yet, I still need
to learn a lot on how to handle the situations especially how to answer them
brilliantly. I’ve been in paediatric oncology ward at other hospital also prior
to this but I have never had similar experiences.
I attend similar group of kids every session so after a few
sessions, I know them quite well. I talk to their parents and their family. I
asked them what they wanted and hope for their child. It was so heart-breaking
especially when I listened to a mother who wanted her only child to get well
despite knowing that he would not survive for so long. And there I was standing
next to her, thinking how to reassure her and make her feel better. I would
just sit and listen, and I couldn’t even say anything. I couldn’t even say that
it was okay nor that I could assure her that her child will go back home as
healthy as before.
These kids really made me think a lot at home. When I was in
high school, I have an ambition of becoming an oncologist. I was so clueless at
that time. All I know at that time, I was going to treat all the cancer
patients and they will heal. But then knowing the fact, it was not as easy as
what I thought. I will never end up as an oncologist. I may sound selfish, but
I wouldn’t want to work hard every day for my patient health, yet frequently, the
word death would still be there at the back of my mind. For me, after a tiring
day, what motivates me to work hard would be my patient health and happiness.
They are happy, healthy, not in pain, able to lead a life that they wanted to,
that would have washed away my exhaustion. Empathy, I guess, is what I am
trying to learn here. I was trying to put myself in their situations. From the
experience that I had of being an intern in a ward, sometimes the doctors are
too busy that they forget to communicate with the patient. They forget that
aside from treating the patient physically, they also still need to know the emotional
state of not just the patient but the family too. I don’t blame those doctors.
I know how hard they are working and giving their best. That’s why I took this
opportunity not to just learn to treat the patient physically, but I am
learning to sit, listen and assure and help them. The patients and their
families are at the lowest state of emotional stability at this moment and they
require support so as a doctor, be there. As what was stated in the Declaration
of Geneva and what we pledged during the oath taking or white coat ceremony,
the health of my patient will be my first consideration, so at the state where
your patients need you the most, be there. You can never imagine the life that they went through. A smile on the face does not tell you anything until you explore what's there deep in their heart.
P/S: Nothing to do with above topics but something I was thinking about as I wrote and think about this write up.
In every job/occupation that we are doing, be sincere.
Sincerity will produce the best outcomes of work that we can never imagine.
To me, the journey is still long and there will be a lot of
hurdles waiting. I know I will not stay as motivated and good as this throughout the journey. I know sometimes, I will end up being frustrated, being negative but I hope I will reread all this to help me stay on the right path. Along the way, I believe I still need a lot of improvements
and fixations hehe. After all, tough times makes people stronger.
Peadiatrics yes? No. Oncologists yes? No. I got a fragile heart. I can't work here.
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