The world is too much with us
A month ago, at my very first topographic anatomy class or in plain words, the dissection a human remain, I was ready to make my first cut. It’s a holistic moment for a doctor; it’s like taking the first step in life for a toddler. But at that very moment, my teacher asked us to hold on to the scalpel and contemplate for a moment. He said:“It takes 10 years for surgeon to learn when to cut, it takes a lifetime to learn when not to.”
In the face of diseases such as cancer, the most optimistic option is usually surgery, which means cutting. Cutting out the cancer in the gut, in the chest, in the brain and hope to be cured completely. Despite all those drastic surgical procedures, a recent big data research indicated that the survival rate for cancer patients didn’t change, and those invasive procedures actually cost the patients their last peace of life. The world is too much with us waving the knife, trying to be the hero that takes off the head of the dragon. But there is more to life than being a hero, there’s more to life than cutting.
Once I was observing in the ER, and an old lady with a massive heart attack was brought in. If she were any other patient, the doctor would slice her chest open and put his hand on the heart and plug the hole in the heart. But that old lady was DNR, which means do not resuscitate, put down the knife, turn off the monitor and call time of death. But the doctor continued doing CPR in a very slight manner for 45 minutes. Later I realized those 45 minutes gave her husband the decency to accept the pass of his love of life, offered the old gentleman the chance to kiss his loved one goodbye, gave one last grand gesture to the end of the patients life. The practice of medicine is more art than science. It transcends the huge gulf between life and death. The world is too much with us cutting. Learning when not to cut, giving respect to life is a lifelong lesson.
I am on this team studying Parkinson’s disease, something like the Alzheimer’s. At least 20 years of research has poured into this field, and the sequence of DNA that went wrong has been identified, but there is still very little progress in terms of treatment. Patients are still trembling, still not being able to walk, still slowly forgetting about themselves and the world around them. Then, I was introduced to a device invented by a 14-year-old boy. His grandfather who had Parkinson’s disease often wanders off in the middle of night, causing great liability to his parents and deep guilt to his grandfather that he intended to suicide. So this boy invented a simple pressure sensor, and bound it to his grandfather’s sock. Every time his grandfather gets up in the middle of the night the sensor sets off an alarm to the smart phone and wake his parents. This simple device, being invented by a 14 year-old is actually more pragmatic than decades of heavy research. The world is too much with us scientists who try to cure everything with a sole solution, while simple and low cost inventions that can improve patients’ life quality and their dignity are being missed.
The oath I took when I first get into medical school “ to cure sometimes, to relief often, to comfort always” is a life long lesson. The world is too much with us cutting, the world is too much with us curing, and, sometimes, it’s just nice to take a minute to comfort.