"It is not the world I hope to change; if I could make a person's world better, I have done my part."
Two weeks ago, right after my first year exam, Ailani and I took the first weekend call. Needless to say, the call left me sleeping like a log the whole of the next day. I couldn't even afford the time to breathe a sigh of relief that exam was over, that despite what I had gone through, and still was--am--I didn't do so badly.
But this post is not about that. During the day, we received an urgent referral from Kuala Krai. A 16-year-old boy had met with an accident while riding his motorbike to school earlier in the morning. The accident occured at Kuala Lipis, Pahang, which was four hours from my hospital. He was comatose on arrival at the clinic in Kuala Lipis, where he was immediately intubated and rushed to Hospital Gua Musang. Unfortunately, the hospital doesn't provide CT-imaging and because of that, he was brought to Hospital Kuala Krai. Even then, the hospital was a good two hours away.
When the boy finally reached HUSM, a good seven hours had passed since the accident. He was stable, and since the intracranial bleed on initial imaging wasn't all that bad, we decided to insert a catheter to monitor his intracranial pressure. To my dismay, the pressure was well over the upper normal limit. Medical therapy did not help much. My specialist told me to operate on the boy post-haste.
It was over a year since my last bifrontal craniectomy. In our program, the first year is dedicated to strengthening the basics of neuroscience as well as clinical skills. I have to be honest: a part of me was itching to operate again. Thankfully surgery is somewhat like riding a bicycle or driving a car. Once you get the hang of it, you can spend time away but when you're behind the wheel, everything comes back naturally.
The surgery took me two-and-a-half hours, from three to five-thirty in the morning. Not my best time, but the patient was bleeding copiously. But what's more important was that the patient's intracranial receeded back to normal after the surgery. However, I had to prepare his parents for the worst. The patient had severe brain injury, and chances of survival were guarded; chances of recovery were even slimmer.
One thing I can tell you is that children are resilient. I don't know where they get their strength, but they are not as fragile as we believe them to be. This particular patient is no different. Against all odds, he not only survived, but recovered. When we thought he would need tracheostomy to facilitate ventilation, he proved us wrong. Within four days, he was extubated, and was transferred out of the ICU to the acute trauma ward. He was also able to respond to his parents, and was able to eat normally.
Earlier today, the patient was well enough to be discharged. He was sitting on the wheelchair, and he was smiling. He may or may not have understood what was happening, and he still wasn't talking, but this was the same patient we had expected to remain in a vegetative state, if he survived the first fourty-eight hours.
The patient may or may not fully recover; only time will tell. Life will definitely be more challenging for his family, and he may not be able to reach his full potential, the potential promised to every growing child. But everytime I looked at his parents, I could clearly see that no hardship would be too difficult.
Because their child lived. He's still living, he's still with them.
When I sat for the entrance interview, one of the consultants asked me why I decided to pursue Neurosurgery.
"Because people have the impression that a patient under the care of neurosurgeons will either die or end up a vegetable," I say.
"So you want to change how people look at Neurosurgery?" he said.
"No. I don't care what people think. I just want to heal people, one person at a time."
That was my answer, and it was the entire truth. It still is, and whenever I start to lose track of my goal, miracles like this patient occur.
I am not the sharpest tool in the shed. I doubt I will have publications in international journals (one can always hope), or make groundbreaking discoveries. I may end up publishing stories instead of medical journals, and novels instead of chapters in neurosurgical textbooks, but it matters little to me.
Because I treat my writing like I do with my day job. I'm not interested in changing the world. If I can touch only one person's heart, if I can make his or her world a brighter place even for a flickering moment, I have done my part. Mr Saffari, my boss in HKL, told me to write stories and blogposts about neurosurgery to raise awareness. He also advised me to keep honing my surgical skills, and to keep learning to improve myself. Because of this, I don't mind being the candidate everyone else loves to hate. I know I'm doing the right thing.
Let me heal people. That is all I ask for.
