Today’s article will be more pensive than usual and perhaps herein will be more questions than answers. It is not intended, by any stretch of the imagination, to be esoteric (only for those with specialised knowledge). Whilst the quality of individual lives is quite variable, in a purely scientific sense, to my mind, there are only two possible constants to life. Either one has a life, or one does not.
In my profession, death has been an ever-present reminder to me and many of my colleagues of the sanctity, value but especially the frailty of life. I vividly remember my first encounter with seeing someone slip away. She was ill; we knew that there was nothing more as physicians we could do for her. As an intern, I disliked having my pager wake me out of what little sleep I would get to attend to a non-urgent matter. Therefore, I developed the habit of doing a ‘walk-through’ on the wards to make sure as much as was possible, all was well.
On this particular night, I looked in on our patient one more time and to my inexperienced eye it was clear that she had worsened during the evening hours. I asked the nurses to page my registrar (senior doctor) and he quickly came and she was reviewed. We all agreed that she was not likely to make it through the night. As he was on his way out of the door, I had just whispered good night to her when I realised she had stopped breathing. I quickly ran for my registrar and we tried to resuscitate her, but after several minutes, we stopped. She was gone. She was dead.
I couldn’t control the tears. Surely, I had come back to the ward on other occasions and realised patients were missing and had died, but never had I seen anyone die. Heart-wrenching is the best way to describe the feelings I experienced that night, and many more nights during my career. So why the morbid discussion on death? Let me explain.
I recently came into contact with a wonderful elderly gentleman who was ill but not so ill that in my mind he should die. The most important point in his history was the report from his relatives that in the previous months he had given up on life and seemed to be content to die. This is where I find myself philosophising. Do we, as mere human beings, have the ability to determine whether we live or die?
It is inevitable based on the way the body works, that if one does not eat, drink or sleep, the outcome will be death since these are the basic necessities of life. However, what comes to mind is that patient who perhaps is writhing in pain from a terminal illness who seems to decide he or she has had enough, and just lets go of life.
Perhaps we can contrast two patients who have each been given the same diagnosis of advanced illness. One patient decides that he or she will beat this illness; the doctor does not have the final say in the outcome of the disease process. The other patient decides that this is the lot he or she has been given and whatever happens, happens. More often than not, the first patient has the better quality of life and, in some cases, defies the prognosis of the doctors. The other, ‘after a brief illness’, is featured in the local obituaries.
It stands to reason, therefore, that if by not wanting to live one seems to die, then perhaps we should use the will we have to live the best life that we can. Whilst thankfully to my knowledge, I am in generally good health, a few years ago I underwent a procedure that required sedation. I vividly recall saying to my doctor, ‘Good night’ to which she jokingly responded in the same way. The next words I heard were, ‘Ok, Renee we are all finished.’ What?? I felt nothing, I knew nothing and the only clue to my prior sedation was that I was a bit unsteady on my feet.
As I was wheeled to the waiting room, I had this sobering thought that plagued me for a few weeks afterward. I was essentially dead. I was not aware of breathing, hearing birds tweeting, or my children laughing; I was not, for that given period in my mind, part of the land of the living. As a matter of fact, my mind did not exist because I was unconscious. So, having been brought back to the world of the conscious, I in retrospect, understood what it was like not be alive.
The frailty of life hit me like a tonne of bricks and equally earth-shattering, the resolve to make life count consumed me. I made it my business to hug my children and husband more and to spend less time worrying about the clothes on the living room chair which precluded me from sitting comfortably. I wanted to make my life count for something so I began to learn about my skills and talents and how I could best use them to fulfil my destiny. I spent less time becoming irate at the insolent drivers on our roads and began expending my energies on encouraging those with whom I came into contact.
I certainly have not perfected those changes as yet because the trials in life certainly can weigh heavily on one’s shoulders. However, I am determined to live my best life and extend a hand to others to help them to live their best lives. To be a ‘walking dead’ is a waste of time, energy and space. Use the air we breathe and the brains we have to positively change our world. To live or not to live… that is the question. Or is it? The more important question is ‘How are we going to live until we die?’
(Rénee Boyce is a medical doctor, a wife, a mother and a Christian, who is committed to Barbados’ development. Email:firstname.lastname@example.org)