Sunday, April 22, 2007

Don't Wake Me Up

"Have you ever been, completely and utterly, destroyed?

Have you ever suffered so grievous a wound, so deep a pain, that the very act of living is excruciatingly painful? That it went straight to the core of who you are, and changed, for you, what it meant to live? To be human?

I loved her. And what's better, she loved me. My first love. And the universe was fair. The world was beautiful. For all its sham, drudgery, suffering and broken dreams, it was beautiful. I could live through anything that happened, because there was someone by my side. Someone to share everything with. Someone you knew would be there for you to rush to no matter what happened. Someone to face the world with. Your own little corner of God's great universe wasn't so small and lonely anymore.

And whilst it lasted, it lasted beautifully. You'd walk in the park, and see all these couples holding hands, and you'd smile. You'd pass a corner cafe, and see young lovebirds gazing into each other's eyes and laughing, and you'd smile. You'd pass billboards in the street advertising the latest romantic blockbuster, and you'd smile. Because you had someone to watch it with. You had someone to take walks in the park with. You had someone to sit down and laugh with, to pick up from work, to take to dinner, to fight with, to cry with. You had SOMEONE. Someone who fit you. Someone who completed you.

And you could understand how the world kept going on, despite all its tragedies, injustices and sins. Because people were still in love with each other.

And then it happens. Things grow old and die. Nothing lasts forever. All happiness fades away eventually. The bright days grow dark, the black clouds cover the sun, trees shed their leaves and grow bare.

Suddenly, she's gone.

And you're left alone to face it. No explanations. No one to answer your questions. You're lying on the ground, gasping in pain, trying to comprehend the blind horror of it all. You're reaching out for help, you turn to everyone you knew, asking for some sympathy, some support; you don't feel like living anymore, and you've lost the fear of death. In fact, you think it might be better off to die; to float up, far far away, and return to the arms of the Creator. Whatever supreme being is up there waiting at the end of this journey, He might have some answers. And comfort. Some soothing relief from this blinding pain.

Because no one else can offer you any. Everyone around you is wondering why you're so weak. Why you can't be a man and deal with it. Why you're wasting their time telling anyone who'll listen how painful it is. Everybody breaks up, and they're still walking around. What's wrong with you? The world is full of tales of broken love. Everyone's got a tragedy. Take it like a man and get on with it.

So you keep it inside. You walk around with this deep, searing wound within you, a pain that goes so far down into your core that it's become part of who you are, and you plaster a smile on your face and pretend that everything's okay. You walk through the park, you walk past cafes, you walk under billboards, and you pretend you don't see anything."

He sighs and fidgets with the IV line in his arm. For a long time he stares at his own feet, making impressions in the hospital blanket.

I sit there looking at him. I do not speak. The Patient Interview handbook stays clutched in my hand, forgotten.

After a while he perks up. "But last night she came back to me." He smiles.

"Last night I dreamt of her. She was standing in a field. She'd hurt her foot. I bent down to help her, and she kneeled. I teased her for being a klutz. She always was. She laughed, and I smiled. I felt happy for the first time in years. I wanted to tell her how sorry I was, how much I loved her--"

He stops. A single small tear rolls down his cheek. His expression hardens, but he continues staring into space.

"And then he woke me up."

And he looks up for the first time, staring at the nurse standing a few beds away. His expression contorts into one of pure rage. But he does not say anything. He knows the nurse is innocent. But he needs somewhere to pour his anger and his heartbreak. In this cold world of unfeeling, uncaring people, he needs somewhere to vent.

He turns to look at me. The moment of rage is gone. "You're young. You of all people should know how it feels to have a really good dream interrupted."

I try and smile. I am no stranger to pain. I know what he must have gone through. This man, this former drill sergeant, who fought in some of the worst wars of our time, who has seen men die under a hail of bullets, comforted grieving widows and suddenly fatherless children, this man knows pain.

The sound of chairs being drawn back makes me look around. The other medics have finished their interviews and are leaving the ward. I turn back to him, unsure of how to make a gracious exit.

But he smiles. "Go, young man. The best of luck to you."

A week later, he is gone. I find out from a patient follow-up meeting. He went peacefully, in his sleep. The night before he died, his condition had worsened. His last instruction was "Don't wake me up".

I find myself feeling glad. I do not know if that makes me a horrible person.

Picture credit: 'Outline of a Love Lost' from abstrusezincate


Emirin M K said...

"Suddenly, she's gone".

I know how that feels like. I'm touched by this. Truly, I am. *sob* *sob*

Argus Lou said...

It does not make you a bad person, Angry M. It makes you an empathetic one.

Death is a natural part of life. It isn't bad either.

Anonymous said...

Each of these experiences makes you a better doctor and a better person. Let it touch you, but do not let it destroy you.

If you fail to let these experiences touch you, you'll become a cold hearted bastard.

If you let them destroy you, you'll have a broken soul before you're 30.

The trick is striking the balance. Far too few doctors manage to do this. I hope you'll be one who does. We need more of that type.

Cal said...

Aww, Angry. This post is so moving.

Of course it doesn't make you a bad person. No one enjoys another human's suffering, and it shows how empathetic you are.

I don't know what else to say, so I'm going to leave it at that.

Aside from telling you to bin that effing 'Patient Interview' handbook - I'm gonna go out on a limb here and venture to say that I'm sure you'll survive just fine without it.

Tara said...

Great post! =) You will be a wonderful physician.

Anonymous said...

He's not going to be a physician, he's going to be a surgeon.

ananddave said...

u aint alone homeboy...u got d end...u noe dat...n i noe d pain u went through...i was there...always will b there man...:)

SeaSpray said...

Hi Angry Medic - I FINALLY posted on my Apprentice opinions! BEWARE if you didn't see the end yet though as I mention the winner. First I gave predictions and I was ,Ahem - right on and then I posted after thoughts.

Have a great day! :)

tscd said...

It's good that you respected a patient's wishes not to be resuscitated. CPR is painful and horrific - and definitely not a peaceful way to go.

Anonymous said...

"Suddenly, she's gone".

That's were he was wrong. She never did leave.


the little medic said...

What a moving and inspiring post (not your usual stuff eh angry? ;))

Joking aside, it doesn't make you a bad person at all. Sounds to me more like you're going to be a great doctor. Don't make yourself feel bad for showing some empathy!

And I'm with cal.... bin that handbook, there is only so much you can learn about communication by reading a dam handbook.

zoo said...

At least he can't be sure she did.

Eugene Lau said...

(Wake me up)
Wake me up inside.
(I can't wake up)
Wake me up inside.
(Save me)
Call my name and save me from the dark.
(Wake me up)
Bid my blood to run.
(I can't wake up)
Before I come undone.
(Save me)
Save me from the nothing I've become.

Bring me to life.

Anonymous said...

See, I always thought evanenescence's songs were about Christianity.

dan said...

eugene, you are one funny bugger

Cal said...

Just out of curiosity, anon... What makes you say that Angry's going to be surgeon?

Angry hasn't even done any rotations yet! Give the boy a chance to decide!


E said...


Theer are some who say that surgeons do everything but know nothing; physicians know everything but do nothing, and pathologists know everything and do everything, but 24 hours too late.

Though an over-simplification, there's an element of truth in it.

Surgeons are people who love to do things. Contrary to popular opinion, they need to be excellent communicators. Angry may be a Cambridge medic but he strikes me as more of a do-er than a thinker.

Physicians like to use long words; talk about rare things which the patient doesn't have, and order complicated tests.

Alternatively the above could be tripe and you could just say I have a gut feeling ;)

Midwife with a Knife said...


dan said...

maybe he knows angry medic personally..

MedStudentGod (MSG) said...

Far from it. Instead you realized exactly what made this man so angry - being trapped. He knew he was going and looked forward to it. Too often people aren't able to accept their lives and try to extend the inevitable. You've no reason to feel sorry for someone who's life has meant fulfilment.

Kenny Mah said...

Very tender, soft writing here. The palpable sense of regret and loss. You just coloured the rest of my day a slow shade of blue, but you know what? I don't think I really mind.

SeaSpray said...

What a touching post. I am sorry that I hadn't read your post when I came in to let you know I posted about the apprentice. I was rushing to go in and see the show. However, geeeee - it was so out of place for me to put that there!

What a beautiful story. Patients have so much to offer us in sharing their life's experience, etc. You are very empathetic and your patients are blessed to have you. So often, people are discounted and pushed aside.

I am sure he is with his wife now. That is something to be happy about. :)

Kak Teh said...

aaah, what a lovely post. It is so touching too. and no, feeling glad doesnt make you a horrible person. take care - a mak cik blogger.

Chrysalis Angel said...

You touch my heart A.M.. I knew from his dream he would be with her soon. What beautiful writing.

Not Nurse Ratched said...

Jeez. Jeez. Now I am starting the day off feeling maudlin. Very moving post!

former lesser being of leisure said...

I thought with the cyclops mask TAM would surely be an aspiring pathologist :)

But agree he seems more like a surgeon ;)

medstudentitis said...

It doesn't make you a bad person. A good death is as important as a good life.

Ms-Ellisa said...

That was beautiful. For feeling that way, you are a beautiful person and a good doctor - because a good doctor has to have a heart.
Because you are a good doctor, and have a heart as well, and really care enough for someone to feel relieved that his pain ended, you must be a surgeon deep down because they rock. ;-)

Anonymous said...


Cal said...

Who's the weirdo above? EMIGRATE?? What? To where? Why? For what purpose?

Hmm. I think that we should let Angry at least enter a hospital (apparently, they don't let medics do that at Cambridge, huh Angry?) and see how his rotations pan out.

People always put me down as a surgeon rather than a physician and initially I thought that I would enjoy a career in surgery too, but the more I see of surgery, the more I lean towards medicine.

Of course, it is all down to the person and personal choice - I'm sure Angry will be absolutely awesome at either - medicine or surgery. (When he's eventually allowed in a hospital, at any rate!)

Mother Jones RN said...

I'm sitting in the middle of Panera Bread, and I'm crying. What a powerful post. And no, you're not a bad person, you are a gentle soul who is happy that someone is no longer in pain.


ditzydoctor said...

awww angry. that was so unlike you! i just cpr-ed my first patient, he didn't make it so i'm really glad yours died peacefully. it's the best way to go, being in the resus room sometimes makes you want to tear out your hair and weep. great writing there by the way, v touching! and i think you needn't worry about tackling medical life beyond medical school. :)

i don't think you're a bad person, i think, deep down you're really nice and sweet (awwww) and you're just happy to see his suffering end. thanks angry =D looking forward to more from you!

CS said...

I'm here via Voyager's blog. I think sometimes death is a blessing. One of my most intense cases, and one that I remember like it happened yesterday although it was 14 years ago, was a Korean War vet dying of bone cancer. He had holding for many months, in unrelenting pain, until the day we talked about his fear of being seen as a quitter. I said there was difference between quitting and letting go, and he seemed profoundly relieved to hear that. He died the next day.

Kenny Mah said...

P.S. You can use the email addie I left the last time, bro.

Nostrumdammit said...

With that demonstration of empathy, sensitivity and eloquence you are already a fine clinician.

Maintain Course TAM!

I look forward to surviving to the age when I can peruse a leather bound folio of your collected musings.

Anonymous said...

Angry Medic,

What a lovely, sad story. I know you will be a really wonderful doctor. That is why I posted to you re your statement about being so eager to start "ripping patients apart and sewing them together again..." on Dr. Orgin's blog. I mentioned I went through a really bad time a while back, and how I wished you had been there, because if I had had a medical student or resident to do all the stiching and stapling, someone who wanted a chance to pratice and learn, maybe something good could have come of it all...instead I got truly "angry medics" who were just pissed off at what I had done to myself...not that I blame them. Anyhow, I am kinda hesitant to post this, afraid you won't want a nut job on your site, but your joking comment reminded me of my actual thoughts...hope it's okay....and thanks again for the VT symbol and for an excellent blog.

Sincerely, tracy in va

The Quiet Storm said...

Poignantly beautiful! But you as a doctor needs to be emotionally detached with your patients so no, youre NOT a horrible person!

The Angry Medic said...

Thanks, guys. Really. I'd like to reply every comment on this thread individually, but I want to move on from this post. So thank you. Your comments really touched me.

And I DO want to be a surgeon. But like Cal says, we'll see. I might not be cut out for it :)

Tunku Halim said...

Good writing my friend. Very sagacious.

My Own Woman said...

I don't know if he's a doctor, surgeon, pathologist or psychoanalyist. Hell, he may be a psychopath for all I know. But, in that brief minute when he felt, he was most definitely a compassionate human being.......something wonderful for which to strive. I'd have to say Angry Medic, you just had a touch of Personal Nirvana. Kudos!

passing by said...

I'm supposed to be writing something about the idiots who go to libel courts, as if it mattered. It doesn't matter, it just doesn't. You keep going. That matters.

Lim said...

My heart is very touched. Very moving post - thank you for sharing.