The echoes from the past sometimes bring the cascade of memories tumbling down into the mind’s eye and the play goes on, for a while, lurching us into the sweet confines of the embellished past. The soft cool touch of the winter when a snow blizzard crippled a city and I had to walk a few miles to the hospital as an intern picking up snow from the sidewalk edges and making small snowballs as I walked the distance. I was confined to the hospital for 76 hours on duty because some clever ones called in their absence. Yet those 76 hours shaped my mindset to a certain degree. Mind you, the occupation of that far-off past experience infrequent in its periodicity still reverberates whenever I see anyone ill, especially a young child. The adult always brought out all my desperation to seek an answer while the younger ones tore me up and broke my heart.
No, I never became a Pediatrician. I chose instead the hearty and heady concepts in adult cancer medicine. Some call it the field of Medical Oncology. I found Embryology as deeply embedded in that field as Immunology and all together both these fields conversed with Pathology on a constant basis. So began my love for Medicine. To dig deeper into the causal stimulus that initiates the process. To find the switch that turns on the motor of the mechanism when it goes awry. To tailor thought dedicated against that switch or lever or the entire mechanism itself. To heal the body ravaged with the massive army of unwanted deserters parading in single file or in clusters to occupy and destroy the very mechanism that gave birth to them. To deploy an army of knights against the knaves, the looters, the deformers, and the harm lurking within, and vanquish them all.
Alas I was never able to find the switch or the lever. The one gene-one disease movement that was heralded at the dawn of Ventnor’s Human Genome Project slowly gave way to a more perplexing theme of catacombs and disabling dead-ends. Oncology became a fishery of finds with the fishing line often catching the occasional sodden leather boot discarded into the open sea.
The chemicals and the biologics against the malady, all weathered against the relentless march, sometime successful and sometime distressfully unrewarding. As we dug deeper into the rabbit hole of the science and mechanics of the cell gone awry, we found a world of tunnels, ladders and chutes that kept whipsawing us back to the beginning. The 100,000 functional genes turned into 25,000 and then got whittled down further as the tinier molecules of the RNA became the disrupters, modulators, expressing over or under the message of the genes. The roll of dice, the chaos theory, exposure, and Heisenberg’s Uncertainty Principle all seem to come and play. The world of Medicine seems to be inextricably linked to the world of Physics, Biochemistry, Quantum Dynamics and to Life itself. The golden weave in the golden ratio within the DNA helix and its interactions with the stray electron became a target of the intelligent minds. Modeling blossomed as an art form within the science, as probability ushered outcomes, and the whole complex turned into a tapestry of minutiae: each invisible path convulsing with another in an intricate dance from the onslaught rigors of the ethereal ions that still keeps us guessing.
Yet in the awe-inspiring days as a clinician, I learnt about the magnificence of the human spirit. Of the man who would defy time and live a year past his allotted hour only to wander into the undiscovered country after he had seen his beautiful daughter, the apple of his eye, wedded to her beau. As the sun set that evening and the married couple chartered off to their honeymoon, and the twilight spread, he closed his eyes.
I have witnessed many a storied tales in real life of men and women, who gather themselves and their emotions and walk through the maze of reconciliation with their personal approaching end, with dignity and grace. It is a reward few get to see. I have witnessed the courage and wisdom in the face of blanketing darkness of adversity and tumult with nary a crack for escape. Yet the spirit lives!
And many more, than I can count, are images imprinted into my mind’s eye of those that got spared from the ravages of this terrible illness called cancer. Some went on to marry and have children and others lived to see their grandchildren. I don’t take any credit for this. I believe they had it in them to be victorious against the scourge. I, on the other hand, only guided them through the murky maze as best I could.
The human mind is a powerful weapon against adversities. “Mind over Matter,” does have meaning. It is the form of armor that makes us who we are supposed to be. Perhaps in these days of easy access to all access where humility takes a backseat to the collectivist “drown the other,” mentality. A pause, a hesitation, a momentary reflection of what we are made of, might take us to a better place. Learning that death spares no one and that the short span of life is all we have and with that knowledge, we might relent in our behaviors a bit. That liberty and freedom of thought and action gives joy and hope, while compressing another’s thought, kills that spirit and thus, wisdom. We must all aspire and pour through some history, to advance our scientific thought without prejudice and without being victimized to some construct of right and wrong in the field of science, by those who have a difference of opinion.
It is clear to me, that even under the oppressive assault on freedom of thought, should it ever come to pass, that is, if it is not already here full throttle, brave souls will gather to affirm the losing art of liberty and freedom and use that wisdom to fend off all such adversity. Physicians should be allowed to use their knowledge, experience and judgment to dictate the management of a patient. Yet currently we are governed by the confines of guidelines and pecuniary-coded rules that govern. Some drugs are allowed to be prescribed while others are not, science notwithstanding, even though the latter might have a better therapeutic response. We need to celebrate good individual medical care and not worship at the altar of “one size fits all,” for cost-control purposes.
That 76-hour winter still resonates within me. It harkens the days when freedom to actually care for a person was the right thing to do. Ah those days linger on the tongue of my memory like the taste of fine wine. And a reminder still bubbles within me even in these trying times that bravery and courage do exist in each human soul to ask a question. The spirit may be quiet but it is alive!
At least that is my hope and prayer.
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