White Lather.

Lather with soap, rinse under running water and you’re done. Right? Wrong, if you’re a doctor, nurse, or medical student, that is. There’re seven steps to washing your hands- and a good reason for that too. Each year, millions of people all over the world, doctors and patients alike, fall ill in one way or another, and spread preventable infections all over because of their neglect of a simple procedure done properly. Medical students are always told: Wash your hands after seeing a patient. Wash your hands before seeing a patient- in the hospital, you don’t want to be spreading germs from patient to patient! Wash your hands, wash your hands, wash your hands.

Rub them together till they’re covered with White, White lather. Rinse them clean and dry them.

The hospital ward, unlike what they tell you, is a colourful place. There’s the colour of blood, phlegm and injury, the colour of flowers in baskets, and the colour of stories told in florid detail. As you walk through the patients’ beds, you see lives, stories, and dreams all interweaved together in colorful tapestry- black grief, grey resignation, scarlet frustration, and then, a face painted turquoise with nausea, or yellow with jaundice.

Mdm R was crying when I went to visit her again. I had been visiting her every day since the day I dropped by to say hello. Her grey face, wet with tears, lit up at first and then immediately crumpled into a moanful sobbing. Reaching out to me with both hands, she kissed both my cheeks and cried, “Sayang (my love), sangyat sakit (it’s so painful).” Her left foot, tied in a bandage, was turning black with gangrene, and it lay next to her right limb, which already had its foot amputated.

There is an old saying- that as doctors, we can cure sometimes, relieve often, but comfort always.

We owe it to our patients to be the greatest teachers we’ll ever have in medical school. For letting us into their lives, telling us their Stories, unveiling a part of themselves so intimate that they would not tell another soul. Sometimes I think, perhaps they find it easier to cry on us, than in front of their families. So I did the least that I could, talked with her, listened to her, held her hand. Contrary to what most would like to believe, doctors rarely cure patients completely, if ever. Only God can.

My clinical groupmate, Jr and I, bought her a flower on the first day we met her. One afternoon after our work, we sat down by her bed, listening to her Stories. Just as we were about to leave, she started to cry again. Since then, we visit her everyday. Yesterday, as she kissed both my cheeks again, I sensed something was very wrong. “Sayang,” she sobbed, “ ini mau potong (they’re going to cut off my other leg today).”

She is crying on me, and she cups her hands above her head and cries, “Oh Allah.”

I hold her hand and tell her God understands, and that He doesn’t look at how many hands or feet we have, but that in heaven, all that matters will be our hearts. She stops crying and a calmness comes upon her.

I tell her I’ve to leave to meet my professor for a bedside tutorial. I turn away and slide into the corridor to wash my hands. Hands clean.

The professor brings us to a patient, Mr T, to learn about the abdomen. Mr T is upbeat, joyful, enthusiastic, even. He allows us to feel his abdomen- “Come, come! You are all bright young students- I want you to become good doctors!” The doctor calls us into the corridor again for a summary of what we’ve learnt- and the conclusion is, he’s dying, soon.

Everybody’s faces suddenly turn grey, grey like rainclouds. We file behind the sink, and wash our hands somberly.

The same doctor whisks us to see another patient with a drooping eyelid, and while we learn clinical examination skills, I realize something is wrong. She looks too wizened, too pale, too frail. In the corridor, I ask the doctor why.

“Oh, breast cancer,” he says. “A recurrence of cancer, after her masectomy.”

A masectomy is a procedure where your breasts are removed because of the spread of cancer.

And afterward, we walk away to squeeze a full dollop of antiseptic handrub to scrub our hands clean.

We hear about an opportunity to observe an operation in the operating theatre. We scrub up and see the most adorable four year-old boy in for an operation, sitting stoically in the waiting room, understanding that they’re about to carry out a procedure to drain excess fluid out of his swollen scrotum. (Mummy, he says, don’t let them cut off my elephant okay?) He buries his head into his mother’s arms, while his mother chats garrulously with the nurses. One notices the tears in her eyes even as she is smiling.

We talk to an Indian man sitting on his bed reading the papers- he tells us about his job, his family, and a blood problem he has. “My white blood cell count is too low,” he says, “I feel weak all over.” But he says this with a smile on his face, grateful that you’re speaking with him. In the same ward on a bed nearby, lays the lady you did your first anal examination on, a primitive but pertinent and intimate procedure. You remember the look of gratefulness in her eyes. Later, when you check their case notes, you realize that the chirpy man hasn’t been told he has leukemia, and that the nice Indian lady has multiple problems with her heart, intestines and kidneys.

Jr and I gave a flower to and drew a card for Mdm K, the lady with breast cancer. Her head is bald from chemotherapy. She is forty but looks sixty. “I’m okay,” she says, “Life is like that, we do what we can to be happy.” We leave her with her presents and withdraw into the corridor. I take a sneak peak behind the wall and see her reading the note excitedly, like a little child squealing with joy. I smile back and she waves like a little girl.

I steal away, and wash my hands.

You whisk into another ward, and see rows of patients hung up to kidney-dialysing machines. An old man groans and moans, tosses and turns, and the pain makes him only but half-conscious. He is gurgling in his sleep, sputtering, and when you touch him ever so slightly, he whinges in excruciating agony.

Being a medical student makes you grow up so fast. You see sickness, agony, healing, hope, tears, outbursts, tragedy, blood, human organs, deceit and warmth- all in a single day. Black grief, blue tears, red frustration, green envy and a yellow warmth during visiting hours. Every patient has a Story, every bed holds an entire autobiographical volume in technicolour.

And at the end of the day, when all the colours are mixed together like colours of a rainbow, we rub it away in White lather, take off our White coats and stethoscopes, and go home.

We wear our white coats, whisking in and out of wards, striding briskly along the long corridors like catacombs, trying to catch up with our harried, ever-busy doctor professors. We wear our white coats, whisking in and out of our patients’ lives, taking them in with stride, trying to catch up with what it means to grow up to fill these shoes that seem so large to fill.

This white coat grows you up so fast. Could it be… too fast?

Looking around at the people along the corridors- students in white coats, harried doctors and worried visitors, it suddenly dawned on me that no one is completely normal. That in some way, we are all doctors, and yet, all patients. We walk along life’s corridors, and filter in and out of the lives of people who need us. We go from bed to bed, dispensing love and care to people whom we think need us. If we’re not careful, pride develops, we take other people’s problems into our own hands, forget to draw boundaries, and become depressed, jaded, burnt out.

In the long run, utter helplessness envelopes you and a sense of impending danger grips you. Danger, because feeling needed and being in a position fit to help can grow not only compassion, but also pride, and that presumptuous feeling of being indispensable.

Has the world’s troubles got into you lately? Tens of thousands of people’s lives were wiped out in the Sichuan earthquake, numerous lives were devastated in Myanmar by Cyclone Nargis, your best friend’s parents are breaking up, you see the poor man begging across the street, hundreds of sick people are in need of medication… you feel compelled to send a cheque, counsel your friend, buy the old man a meal… and before you know it, out of foolish compassion and human pride, you’ve taken on a responsibility far heavier than your shoulders can bear. One day you wake up tired, disillusioned and burnt out, and you spread your negativity to all around you like a germ. Whatever went wrong?

We forgot to wash our hands, that’s what. Wash our hands in White lather, and baptise our hearts clean. When we forget, an epidemic of negativity, exhaustion and cynism breaks out.

I’ve always wondered how many counsellors, doctors, missionaries, pastors stay so strong, after listening to heartache after heartache, and I realize it’s because very often, after every Story they listen to, they wash they hands with White lather, and baptize their hearts in a fountain of Water.

It takes true humility to see your own frailty, to accept that this world is not yours to save, and to submit yourself to an act as simple and mundane as washing your hands. Because it’s true- that while it’s good to have compassion, good to help, good to love, we must care, help and give from a source that doesn’t come from within us, but Above us. Only God’s hands are big enough to cup the worries of this heavy world.

I realize, that the strongest people who stay strong to help others, are those who see their own frailty, and humble themselves before God, to admit that it is His strength that sustains them. The strongest, most helpful people aren’t those who go from patient to patient and bed to bed like a harried maniac, but rather, those who recognize their limitations, and who wash their hands properly after seeing each patient.

After all, it’s important not to catch someone else’s germs, isn’t it? And even more important not to spread them around, right?

Only God’s hands are big, and Clean enough.

So I guess it’s a sound reminder, that to really help the needy, perhaps being humble to recognize our limitations does go a long way.

We do our best to help, do what we can to care, pray and love.

But at the end of the day, remember that we’re all human, and that human beings fall ill, too. So at the end of a long day, when the worries of the world bear down upon you like volume of bad Stories, just remember the good habit that you learnt as a little child- to bring your hands, of brown grime, red blood and yellow snot, to the fountain of living water, and wash your hands, wash your hands, wash your hands.

Rub till White lather appears. Rinse properly. And dry.