The Balance of Life: "Roja"

I decided that in addition to using this blog to answer your medical questions, I can also use it as an outlet to share my experiences around how I've grown as a physician.  Below is a piece that I wrote during residency to reflect on my emotions when struggling with the balance between being a good physician and being a loyal granddaughter. I hope you enjoy it!

Roja

My work day at the hospital began just like any other. There I was weighed down by my White Coat of Responsibility. My right pocket was stuffed with medical information of patients- strangers identified by number, diagnosis and treatment plan, all written on white index cards covered with erratic handwriting and markings in fluorescent green, pink, and blue. Each card had a row of unchecked boxes next to a list of tasks to be completed: discharge paperwork, follow-up attending note, physical therapy consult, call/inform family, etc. My right breast pocket was adorned with a colorful display – green highlighter, pen light, purple pen, my 4-in-1 multi-colored “nerd”pen, reflex hammer, cell phone and penlight. Clipped to this pocket was my ID card, a picture of me from the first day of residency looking bright eyed and excited for the times ahead.

My left pocket bore all my lifelines – a tattered, coffee-stained Internal Medicine Survival guide, a laminated sheet of emergency hospital contact numbers, meal tickets, and a peanut butter chocolate chip Power Bar. Clipped to both my pockets were my three pagers, 2 on one side and 1 on the other for balance. Around my neck I wore a black stethoscope, a graduation gift from my grandfather, identifying me as a Doctor.

My first patient to be seen was Mr. Clark, a 55 year old alcoholic admitted for detox. Overnight he pestered the nurses to discharge him from the hospital so that he could get a drink with his friends at the local pub.

I knock on his door.

No answer. 

I slowly crack open the door. “Mr. Clark? Can I come in?”  

“Get the hell out of here!” he says while his eyes remain fixated on the Geico commercial on T.V.

“Mr. Clark, I just wanted to come check up on you.” I take three baby steps closer to his bedside.

“Stop right there! Sign my release papers, and then I’ll think about talking to you!!”

Throughout his conversation, my cell phone continued to vibrate in my pocket. It was my mother. I hit Ignore. I wasn’t ready to give up with him just yet.

“Mr. Clark, I understand that you want to leave, but I think it’s important that you stay here just one more night so we can help you get better.”

“The only thing that is gonna make me feel better now is a drink.”

 I was prepared for that answer, but before I could start my recitation on why we needed him to stay in the hospital and why alcohol is evil, I was interrupted yet again.

“Please call 6205-6205,” commands a female voice over my pager. All the while my cell phone continued to vibrate over my fast beating chest with new incoming calls.

Off I head to the Nurse’s station to answer my page. Surrounding me were the sounds of cardiac monitors chiming, phones ringing, nurses laughing and gossiping in the corner, and a demented man restrained to his bed screaming in the hallway.

Once again my pager summons me, “Please call 6205- 6205.”

“Excuse me,” says a voice from behind me. “Are you the doctor covering Mr. Jones? He needs paperwork done and he’s been waiting since 7 am.”

 “Oh, are you with Team 3? You forgot to sign this order,” says another voice on my left.

 “Please call 6205-6205,” continues to repeat in my pocket.

My cell phone continues to vibrate. Who is calling me? I angrily utter to myself. On the flashing cell phone screen, I see five missed calls from home. I reluctantly step aside from the Nurse’s station to return the call.

“Mom? I’m really busy. What is it?”

“Hi honey. Are you doing okay?” she asks quietly.

 “Yes, I’m at work and I will have to call you later.”

“Honey, I tried to call you because I need to tell you something important.”

“I hope so, because I’m in a rush….”

“Grandpa just died.”

And with those three words, my whole world went silent.

There I was with my grandfather, exactly as I remembered him last. We were on vacation in Myrtle Beach, sitting together on a bench overlooking the sparkling crystal blue ocean. The waves crashed in the distance, I felt the warmth and humidity of the sea air through my skin, and I tasted the salt of the sand on my lips. The gusty wind swept  my hair into my eyes and mouth, and my grandfather pushed my hair back with his hand.  I turned to look at him, and the glaring sun only allowed me to see the shadow of his face with a halo surrounding his darkness. He looked so holy in that light, just like any guardian angel should.

He sat closely to me, with my head on his shoulder and I could hear his every slow breath. I could smell his Old Spice cologne which he would never go a day without. He used to say he had only 2 things he couldn’t live without: grandma and his Old Spice. I never liked the smell of his cologne; growing up he would catch me spilling his cologne down the drain, and then filling the empty bottle with tap water. Despite all my mischievous acts, he never yelled at me or ever raised his voice. He took my hand and held it softly, rubbing it gently with sweet strokes. No matter how old I was, in his presence I felt ageless. His gentle touch made me forget all the sorrows of the world and made me feel like I was the luckiest girl to have someone who loved me and treasured me as much as he did.  We start to sing together – Louis Armstrong’s “What a Wonderful World.” I begin my solo- “I see skies of blue…clouds of white. Bright blessed days…dark sacred nights. And I think to myself…”

“Please call 6205 – 6205”, says the angry voice over my pager, welcoming me back to my reality.

All my life I dreamed of being a physician and dedicating myself to helping the sick and less fortunate. I love bringing smiles to the faces of those in suffering, taking away their pain and giving them a sense of relief and hope. But who is there to wipe away my tears?

My grandfather was dead, and there was nothing I could do. He had been sick for a few months, and seeing him suffer with no option or answer in sight was like having daggers pierce through my heart slowly every day. All I yearned for was to see his face, go back to Myrtle Beach, hold his hand, and give him one last kiss. Emotionally I felt tormented inside, and the thought of finding someone to cover for me so I could leave the hospital was an even worse option for me. It was my responsibility to stay with my patients and take care of them. It was my responsibility to be at their side, to wipe away their tears, and to bring them comfort. I spent so much time helping other strangers that I could never be there for the most important man in my life during his last dying days. How could I even consider neglecting someone who knew me and loved me so much for a stranger who barely knew my name???  

After seeking out the advice of my colleagues, I finally found the courage to ask to leave the hospital and be with my family. Unfortunately I wasn’t able to make it to see his face one last time. He had been cremated by the time I reached the funeral home and all that was in front of me was a box of ashes with a single red rose on top.  I don’t recall the details of the box, because all I kept staring at was that one single beautiful rose. I kept remembering his sweet voice and how he used to call me “Roja”, which in our native language means rose.

Each day I still struggle to balance my life with work, friends and family, and there are times where I resent myself and the career choices I have made. Through my grandfather’s death I have gained the strength to put myself first, and make sure I don’t live my life with regret.  It is my gift to be compassionate, it is what brought me into this career, and it is what will ultimately make me a good physician. If I attempt to bring love, happiness, and hope into the lives of my patients; I deserve to feel that same sense of joy in my life. Though I couldn’t see my grandfather’s face one last time, I know that he is smiling at me from above and proud of me with every step I take in changing the lives of others and he will be there to guide me to strike a balance with every life decision I make.


Thanks for visiting my blog today. I welcome all your comments. I would love to hear your thoughts!



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