I won’t forget that fateful day, where that white-haired, near-seventy, petite senior doctor picked my two team-mates and myself off the hospital corridor and said, “Are you three medical students? Not having lessons right? Come with me. I like to teach random people at any time of the day, wherever I am. It’s not important to know who I am.”
We later found out she was one of the most senior and respected doctor of the cardiology department, and she whizzed us into the intensive care unit of the cardiology unit. “Listen to this patient’s heart murmur,” she said. “You’ll learn a lot from this.”
I looked into Mr Z’s eyes, to whom the abnormally rackety heart sound belonged to and saw his fatigue, his sadness. His eyes said he was in a precarious situation, and he knew it. Metal things were holding his heart up, clanging and banging against the walls of his vessels and keeping his heart from failing. “These metal valves won’t last forever,” he tells me, “Yes, you medical students- come listen to my heart. Become good doctors in the future, okay?”
The next day, I went back to see this Malay man.
“I’m so sorry,” he says, “that I seemed so grumpy towards you and your friends yesterday. I was just… so tired. So very tired. But I’m okay now and I’m happy to talk to you. You speak Malay well, you know.”
A few days later, one of our professors calls us in for a meeting to brief us on a project we are to embark on.
“Many a time as doctors, many of us have little insight into the lives of our patients. Our contact with them is just in that 7 minutes we see them in a clinic, we dispense medication, and expect them to run along with their lives. This project is to help you understand that every patient has a unique socio-cultural and behavioral background that influences the outcome of his illness. It involves you choosing a patient with a chronic illness, visiting his home, understanding his worldview, family dynamics, financial constraints, his concerns, his whole world basically… and coming up with suggestions to help the outcome of his illness. It involves you following him up for 4 months, and submitting a case report.”
It was easy to dismiss it as Just Another Project. Except that it wasn’t. Entire families could be, have been touched, transformed through this project every year.
“And yes, every one of you are to select a patient each and pay him a home visit. It’s time consuming, I know, but absolutely necessary. A lucky one of you from each team with the most suitable patient will have your entire team visit your patient’s home together with you, chip in to improve his situation and present a group presentation on the case. That patient will be extremely fortunate.”
Many students spend weeks to find the perfect patient. After they do, many often get rejected mid-way as some patients just aren’t willing to follow through to open up their homes and lives to a stranger. Oh God, I prayed, I need a divine encounter. I don’t just want to pick a patient off a shelf- choose him for me, will you? This could be life-changing.
My team-mates come up to me and tell me, “Hey Wai Jia, why don’t you speak to Mr Z, that patient we met a few days ago? You speak Malay, don’t you? He seems to be the perfect candidate for you.”
Ah well, I thought, perhaps. I didn’t get my hopes up. But he was the first patient I spoke to about this project, and he agreed at once. Most students spend weeks to find their project candidate.
To top it all off, I was in shock when my team chose Uncle Z for our group presentation. It meant every student from my team would visit him and chip in to help him out. I had been praying and wishing like mad to get picked, mainly because while I felt so incredibly moved by Uncle Z’s plight, I felt inadequate, helpless, overwhelmed even by his state of affairs.
Uncle Z is unemployed, living in a one-room flat with his wife and child, suffering from congestive heart failure. They have difficulty paying the utility bills every month, and live from day to day. He desperately wants to work, but cannot. He has had multiple operations previously and has been becoming depressed and short of breath of late, losing appetite and weight, too.
Much later, I realized that many of my friends had to spend weeks to find their candidate, and I thanked God silently for arranging that divine encounter on that fateful afternoon.
Uncle Z would tell me, “ I know what I have. I could die anytime.”
“Sabar, Uncle Z… Tuhan yang jagar kamu.” I would tell him. Be strong, Uncle Z. God is watching over you. And his face would strengthen into a smile.
What a treasured opportunity, to step into the world of another man, to, for a moment, see the universe through his eyes, understand the sorrow of his suffering, and yet walk right out of his hell, unscathed, with the opportunity to light a candle in his darkness.
To tell you the truth, I knew I hadn’t the strength to enter his world alone. I was afraid, and stressed too. When I decided that he would be my patient for community patient project, I remember praying- I can’t do this alone, God. I’m really scared. And then chiding myself, You’re scared of everything, Woman. Toughen up and just trust God to provide, will you? It’s not your job to save him- leave that to God. Remember what you told him- that God was watching over him?
Leave it to Him I did, and my, did He provide.
In the hospital, we hide behind our intellectual jargon, behind our medical in-jokes and wear our white coats like suits of armour- and nobody knows our little secret, that for some of us, this is all we have to protect ourselves us from entering the terrifying whirlpool of emotions swirling in each patient’s eyes. The naked truth of a patient’s amputated foot, newly diagnosed cancer or chronic illness stares back at us like a tragic subplot, and the glitz and glamour of surgery, the classy ring of our title as doctors (or medical students), and the sound of our all-knowing voices reciting medical conditions like a digital encyclopedia melts into farce in the stark face of reality.
We whiz from ward to ward, gleefully picking up and learning signs and symptoms from patients, discuss and talk about them, take off our white coats and return home.
Sometimes I think, it is not that we are inhuman that we do not take time to delve into every patient’s life, look into the swirling mess of each patient’s eyes. It is because we are human that we dare not.
But I thank God we have this privilege to visit Uncle Z. He’s agreed to meet all ten of us, including our professor at his one-room flat this Sunday afternoon, to help us understand his situation better, and I can’t help but think God answered my prayers- for me, and for him.
“It’s the fasting month for Muslims, Uncle Z- are you fasting now?”
“No, I’m not. I’m on medication you see, so I can’t… But my wife is.”
“Don’t feel too bad about it, Uncle Z,” I say, as I remember many of my muslim friends and patients sharing with me their earnest desire to fast during the religious month, and their mental agony when they can’t. “God understands, and He knows your heart. What’s important is that you love Him and have faith in Him.”
“Thank you so much, Wai Jia… You know, I don’t even have a sofa in my home, I hope that’s okay for your friends… … You going to church on Sunday morning, right? Yes, you’re a good girl. I’ll see you soon, okay? Thank you for coming.”
God knew I couldn’t walk past Uncle Z’s doors alone without wearing my white coat, without going one step too deep into his valley and crossing from professionalism into excessive attachment. So He sent me a team of friends, and we’re going to take a few steps deeper into his world, see how we can help Uncle Z.
“No, it’s okay, Uncle Z. It’s okay that there won’t be a sofa. We’ll be happy to sit on the floor. Thank YOU for having us, for giving us a chance to learn.”
See you on Sunday.