Navigating Despair and Hope: Reflection on the Limitations and Purpose of Medicine

💭 Thoughts of the week

This week, a patient of mine died from cardiac arrest. It was unexpected. He had been alive only a few minutes prior, with plans to discharge him the next morning. However, he suddenly arrested and, having decided against resuscitation, he passed away peacefully.

That night, I found it hard to sleep. I spent the night replaying the events, wondering if I had done something wrong or missed something. The patient had an extensive cardiac history, and it wouldn't have surprised anyone if he died from an ischemic cardiac event, which is what happened.

As a doctor, a patient's death often feels like a failure.

This reality, understanding our limitations as doctors, is a lesson that medical school never truly taught me.

Our role is to help, not to overcome

I've pondered this fact many times. Graduating from medical school, I had the impression that I could manage most diseases. After all, we have the treatments, the technology, and textbooks full of cures.

However, treating many patients over time has shown me that medicine has more limitations than we often realize.

We have treatments, but does the patient want them?

We have treatments, but what about the potential side effects?

We have treatments, but what about interactions with other diseases?

It's never about us, it's about the patient

The more I understand these limitations, the more committed I become to providing the best possible care for my patients. At first, I was driven by a need to 'defeat' diseases, a response to my underlying feelings of helplessness and inferiority. It became less about helping my patients and more about a duel between me and the disease. But over time, I realized this drive was unhealthy and counterproductive.

Sometimes, we just can't overcome the natural history of a disease.

Sometimes, and most of time, people die.

People die, the question shouldn't always be when, but rather how

I often say people die somehow and someday. Defining a successful doctor is a challenging task.

Is it to cure all diseases?

Is it to help others?

Is it to be a compassionate individual?

Currently, my practice revolves around the idea that I'm trying to provide my patients with a good length and quality of life within my medical knowledge, while going against nature - the source of the pathology.

From a more spiritual perspective, I don't think I can overcome nature and cure every single disease because if I could, I would essentially be the creator of the universe.

This sense of humility fuels my passion for medicine, reminding me that my actions matter. It's within this contradiction - feeling inconsequential to the world, yet impactful to human life - that I find my calling's purpose.

In medicine, we often confront profound helplessness. Yet, it is in this abyss of uncertainty and despair that we discover our capacity to effect change and touch lives. This paradox, this dance between despair and hope, is what truly lends nobility to our profession.

✍🏻 Quote for the week