The Surgical Irony

What does it mean for a doctor to be afflicted with the very affliction they have spent a lifetime treating?

“He noticed an unusual tremor in his hand while operating, and that is when he decided to get himself an MRI, as soon as he finished the surgery,” a friend informed me, speaking about a mentor of mine whose scan revealed a high-grade brain cancer. “For someone who was operating on a tumour the same day it was diagnosed in him, it must have been devastating,” he deduced. My mentor was a renowned brain tumour surgeon, crisp and meticulous in extricating tumours from every crevice of the brain, as he had over three decades. I trained with him a few years ago in North America and we operated for long hours together, me tiring much earlier than him, and I was exactly half his age. He was kind and gentle and revered by all those whose lives he touched.

“It is a sad day indeed when one of our own falls victim to the disease we fight daily,” another senior colleague commented in an email, encouraging the neurosurgical community to send prayers and healing vibes his way for a speedy recovery. It made me wonder what it must feel for doctors to be afflicted by the very affliction they’ve been trained to treat. We know every single hidden truth of that ailment, and more often, the focus is on the negative than the positive, especially if the diagnosis involves a malignancy. We know what can go wrong with surgery, the side effects of radiation and chemo, and, worst of all, the finality of the outcome. And in addition, we are surrounded by colleagues who know the exact same things and yet infuse us with an indestructible spirit of hope, the one we are all expected to portray.

Knowing what we know about death and dying, it comes as no surprise that most doctors would not be willing to undergo the surgery we so effortlessly prescribe to our patients. We know enough about modern medicine to know its limits. And if we have a choice in how to go, we will choose to go gently – not with a tube thrust down our throats and someone thumping on our chests trying to revive a failing heart. I know of a doctor who has had the words DO NOT RESUSCITATE tattooed across his chest.

I wonder what it is that afflicts doctors with the very thing they aim to heal in others, and how it affects them when it does. How does an eye surgeon live the last few years of his life having gone blind? How does a movement disorder specialist come to terms with debilitating Parkinson’s? How does an obstetrician deal with her own miscarriage or a psychiatrist with his own bipolar? How does a spine surgeon recover from being paralysed from a large disc herniation or a vertebral fracture? And yet, it seems harmless and okay to poke fun at a urologist dealing with his own erectile dysfunction or a proctologist who has an anal fissure.

It is possible that there are spiritual laws at play here. There must be a deep karmic attachment to what one desires most in life, and the only way to be truly free is to be completely annihilated by it – a little bit like being in love, isn’t it? That is why when doctors survive an illness, they value the suffering of their patients even more. That is why when anyone survives a critical illness, they view life from a different perspective. Leo Tolstoy once famously said, “One must put oneself in every one’s position. To understand everything is to forgive everything.”

Dr. Madhuri Behari, once the head of the Neurology department at AIIMS, had a stroke while on rounds and was immediately given a clot buster from which she thankfully recovered completely and is still active in practice. In contrast, Dr. Jagjit Singh Chopra, another illustrious neurologist, suffered a stroke while moderating a session at a neuroscience conference; he succumbed in his own ICU, after battling complications of the attack for over a month. Dr. Sorab Bhabha, a benevolent neurologist, passed away from motor neuron disease at the still flourishing age of 52.

The Dr. Ernest Borges road was named after one of India’s greatest surgeons, who spent his life treating cancer at the Tata Memorial hospital; he was struck by carcinoma of the stomach, the very disease he worked so hard to alleviate. Dr. Katy Dinshaw, a leading radiation oncologist who was the director of Tata Memorial Hospital for over a decade, died of cancer herself. Dr. Arun Kurkure, a highly respectable and well-known onco-surgeon, passed away after a two-year struggle with colon cancer. Dr. Nitu Mandke, an eminent city cardiac surgeon, died from a massive heart attack. Legendary cardiologist Dr. BK Goyal, who headed the department at Bombay Hospital, succumbed to a cardiac arrest. Dr. KT Dholakia, a towering orthopaedic surgeon, died after a prolonged illness that resulted from a fracture. The ongoing pandemic has sucked the air out of several intensivists and pulmonologists who fell victim to the virus.

This first of July, we celebrated something called Doctor’s Day. There was an unusual outpouring of love and affection for doctors this year on social media, most of it because of COVID. We were thanked profusely for soldiering the coronavirus war we’ve been fighting, and transiently made to feel like superheroes. And then, as it always happens, a few doctors were beaten up over the next couple of days for a patient who was brought in dead at some hospital and could not be revived. When we are not dying from the diseases we treat, we are dying from injustice and inhumanity and undignified violence – in our country at least.

This year, let’s choose to change things around. Like the famous quote goes, “In a world where you can be anything, be kind.” Don’t curse us; as you can tell, we are already adequately cursed. Instead, pray for us. Pray with us. Pray that we get better in our ability to treat you. Pray that we always do the right thing. And, if you can, spare a few moments and say a little prayer for my mentor as well – a noble man who spent his life healing others. Prayer, if done sincerely, has the capacity to transform, harmonize, and rejuvenate.

“Men die of the diseases which they have studied most. It’s as if the morbid condition was an evil creature which, when it found itself closely hunted, flew at the throat of its pursuer,” wrote a surgeon in a story by Sir Arthur Conan Doyle, a man who gave up the practice of medicine to write stories (for which he was more highly paid) and who, thankfully, died a natural death.

I wonder if I will die operating or writing. Either way, I’ll have a table to lie on.

 

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