Some moving events

I saw two things happen today on the oncology ward that touched me. They are not necessarily specific to India per se, but the way they moved me compelled me to write about them. We started the day with rounds on both inpatient oncology floors. One of the floors, L-ward, is what you would think of if you were asked to imagine a hospital in India; there are approximately 25 beds in one large, chaotic room. Most of the poorer patients choose to be admitted into this room. (sidenote: I think David had mentioned that patients chose their course of treatment based on what they can afford. Likewise, when a patient has to be admitted into the hospital, they choose their bed based on what they can afford, I.e. private, semi-private or "public".) The other ward is called A-block and by looking at it you would have no idea it was in India. The facilities are pristine, dare I say, nicer than some in NewYork-Presbyterian. This is where the private and semi private rooms are, and the patients who choose to be admitted here are either wealthy, middle class, or else have very good insurance. The medicine, however, is the same on each ward, and all these patients go to the same outpatient clinic and are treated the same way by the doctors. L-ward has both adult and pediatric patients. While I was standing in the middle of the room, my eyes fell on a bed in the far right corner. Sitting on the bed was this little boy, not much older than 5, who was hooked up to many tubes and was wearing a bandage on his head. This sight would not necessarily be abnormal, except that on his lap laid his fathers head, collapsed in what looked like hopelessness. As the father laid on the son's lap, the boy simply stroked his fathers hair to comfort him. I was so  moved by the nature of this gesture as well as the role reversal of these two people.  We moved on to A-block, where we have been rounding on these patients almost every day. In one of the semi private rooms is a teenage boy who lost his left leg to osteosarcoma (bone cancer) several years ago. After his above the knee amputation, he underwent several rounds of chemo, but the cancer came back. It has now infiltrated his right lung, more or less turning his lung to bone.  He was in the hospital for these metastatic complications, which included struggling to breathe as well as swelling of his face due to poor lymph drainage resulting from the lung metastasis. Earlier this week we discussed palliative care with him and his family, since his cancer is not curable. He is basically on his deathbed. This hadn't bothered me, but today's rounds were different. Because the swelling was much better and his symptoms were being moderately controlled with steroids, the doctor told him he could go home. However, he was still on oxygen, still struggling to breathe, still swollen, and still without a left leg. What affected me most was that he turned to the doctor and struggled through the oxygen mask to ask him, "do you think I can go back to college now?". I think this struck a chord with me because I thought about my own experience at college. I had no real problems, no real responsibilities, and had a fun, carefree time. And here was this boy who was dying but still wanted to go to school, to learn, to be normal. The doctor told him no.