The Reaper’s Taunts.

Knock, knock. Here he comes. Lurking in his nasty black robe, waiting impatiently to take what is his. The Fate of the Unfortunate.

it’s not that i’ve never encountered death of a loved one, or an acquaintance, or in this line of work - a patient. neither is it that i’ve never felt this same concoction of emotions stirred in my inmost being. However, this time i’ve resolved not to hide it, or put it aside, as if it meant nothing. time to bring out the skeletons from the closet.

Death. what a gory word. in Medicine, we have so many ways to mask the effect of the word: still birth, abortion, miscarriage… the oh-so-famous words in Obstetrics. just recently we discussed the subject coolly, with our specialist, comparing our hospital perinatal mortality with that of other countries, and also of maternal deaths. and today, whilst visiting the labour room, as any inquisitive medical student would, the horrific chuckle of the Reaper rang in my ear - the nauseating sound of Death. two babies delivered as still births.

now, having put my initial shock, horror and grief aside, and despite already learning there were six stillbirths delivered in this hospital this year alone, a multitude of questions started saturating my mind.

is this fair? you know, having spoken to a few people about these two poor souls, some are under the notion, life’s like that. that the good-bad balance on life, karma etc, all make things eventually seem fair. or so it seems. but in spite of all the training to be sensitive, caring and efficient at the same time, we tend to look at patients as part of statistics, as just part of our daily life. without much regard for the repercussions.

what next? much easier for us drs (actually, still doc to be!), since we probably would not see her till her next pregnancy if she decides to. the only probable contact with the health team would be the psychiatrist at the grievance clinic. but for a primigravida (first time mom), do you really expect her to come back to this traumatic experience, with a planned pregnancy? i dunno. i wouldn’t.

who’s to blame? in this part of the world (namely Malaysia), this calls for some major inquiry. what happened? could it have been prevented? what safety measures were breached? in the end, there will be one to be blamed. whether negligence on the part of the mother for defaulting her antenatal visits, or the fault of the obstetrician, someone will take the fall. but, seriously, does it matter? unless of course the doctor was grossly at fault, and could jeopardize more lives, or the mom who is dire need of education and counselling, in hope to remedy her lack of understanding. but not often is that the case. (or due to my "green" experience, i have unjustified cause for that belief. after all, we do believe in "experienced based medicine" too, don’t we?)

having said all that, what have we in conclusion? that death, is inevitable. that seeing and embracing patients’ death is a normal part of our lives, especially as we are the guardians of public health. that once in awhile, it’s good to reflect on these circumstances. after all, we’re human. these emotions are what separates us from all other creatures, and renders us superior to machines. and that finally, death of a loved one, relative or friend, doesn’t just end as that. while we still remain, it’s imperative that we follow along the course of life, with memories of our loss, and a drive to make things better for the coming generations.

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