today is one of the last days of my oncology elective. And I must say, during this period of my oncology elective, I have learnt quite a lot. Inside and outside of the hospital, many things serve to remind yourself that one is never immortal and invulnerable. and no matter what happens, life goes on for if we hung on and clung on to what holds us behind, we will not progress.

Throughout the 4 weeks, i have lost many a friend. It does seem inevitable when you're dealing with the dying but sometimes my heart breaks because they who were once living are now dead. In a space of a few hours, they enter that eternal sleep, never to be roused again. Why them you ask, even more so when you look at the young and youthful cancer patients. That nobody knows and nobody can answer. Maybe God, you can provide some form of salvation for them?

They have told me many things, many events in their lives, although it is ending and the flame is faltering and flickering. But I am glad to share with them their lives over and over again. No life is insignificant even though they may not have made a huge mark upon society or the world. But is there a scribe to be there before their story ends? It kind of reminds me of tuesdays with morrie, you know, the lessons one learns from the dying are always invaluable, for only when you're dying, then you can decipher what life has in store for you and what exactly do you want.

I might sound depressed, maybe I am. But inside i don't feel depressed but more resigned that life has to pass and another passage must beckon. We all fear the unknown, death especially, and more so when you're young and full of promise. When I entered the ward, I was naive thinking that oncology is the department when we would be saving lives with groundbreaking therapies of research etc. But the reality is starkly different. Essentially, oncology is mainly about caring for the dying. yes you have the curable blood cancers and the people who come in electively for chemotherapy. But most of the patients are not so fortunate.

To certify death is not as traumatic as compared to witnessing a person dying. Some people die with dramatic throes of death, some pass quietly in the night. Some vomit blood and spew it forth non-stop, others just slowly ebb away. When I see a patient who has died, i do not think of the failure of therapy, but the peace and end of suffering and pain. It is time for him/her to enter a better world where there will be no morepain and suffering. Desensitization? maybe, most probably but i guess I will never know.

I guess to choose this oncology elective of my own accord was in some ways the best thing i have had, and in some ways the worst. This is not to say I'll forsake my love for surgery, for most of surgery is about oncology to start with. But to throw myself out of the ivory tower and face the real world. People do die, i just tried escaping from it because of my past experiences with death and dying. After my medicine posting, i have overcome my fear of diabetes. After my A & E posting, RTAs are no longer taboo to me already. Yet here you might wonder, do such things exist for me?

Well, yes. Like any human being, I do have intrinsic likes and dislikes and i do love and hate and feel the extremes of emotion. But I have always shown myself as someone who only vacillates between happiness, sadness and anger. Some of you might think of me as insensitive, because i tend to hide my feelings a lot. I can comment non-chalantly about the reason to attend onco rounds daily because of its high turnover rate. But inside, this is just a defense mechanism, to desensitise myself to the implications of that statement, to remove all emotional connotations with oncology in general. How I really feel inside, I would say afraid really, that one day I'll become part of the mortality and morbidity statistic, part of this high turnover rate. Thus I'll laugh it off and present a 'strong' front. Only my close friends I'll share the vulnerable bit.

Well, how do I sum up this entire elective? Well, it is alright to feel things the way it should be felt and one need not hide feelings if it is well intentioned. But more importantly, this posting has taught me on very important thing. Death is a part of life, be it physical death, emotional death or any other kind of death both literal and abstract. We all go through ups and downs and we live to our fullest and sometimes we do die when we drop down from the heights of our wildest dreams. We somtimes die a slow death or it might come pretty quick and painless. But whatever the nature of death, or the method of dying, we must learn to let go for if you don't let go, death will drag you along too. For the living, life must go on after death. grief has its place in life, but grief shall not hold back life for life must go on.

a longer version is available on the other blog.

its a long time since i wrote something like that.


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