Scalpel's Edge

A surgeon's notes

Silent messages

UMN Tansen

Dear Patient,

I know you are sick.  I see you struggle to breathe.  I think you feel awful.  I catch the fear in your eyes.  I wonder why our operation didn’t help you as much as I hoped.  At home, in the expensive world, I know we could measure just how sick you are.  I would know how acidotic you are.  I would know precisely how sick you are, and how sick you become, with hourly updates.  Maybe that would make you more likely to survive, or maybe I would just accept it easier if you die.  Here, I just wait.

Dear Patient,

Your tiny burnt hand will stay with me forever, even though it no longer looks the same.  Your burns are deep, but not too big.   I am sorry that you had to do without pain relief for that week at home.  But you were strong and you made it to come visit us.  I have always been disturbed by cutting into people’s hands.  I know you have many years to adapt, but I won’t ever forget having to amputate your tiny fingers and thumb.  You still have some of your fingers on the other hand.  And you have your big toe. You are comfortable now, but I look forward to seeing you without all those dressings and tubes.

Dear Patient,

I love that you think I am a good surgeon. It makes me feel clever, but I know it’s mainly because my skin is white and I speak Nepali with an accent. It does make me feel embarrassed because I am not that clever. I am struggling to work in an area I was never taught – covering urology and gynaecology and weird tropical diseases.  I wish I knew more about these things.  I would love to know how to explain to you that the guys next to me are just as clever.

Dear Patient,

I love that you greet me and smile at me as I pass in the corridor.  I wonder if I have ever met you or if you just want to say hello. You make me happy.

Dear Patient,

I’m sorry that you can’t stay.  I would like to treat the wound on your foot.  I know you have to go to manage your house and you have no-one to look after you in hospital.  I want to make you better, but you can’t afford it for so many reasons.  I worry that I will have to amputate your foot one dayl.

Dear Patient,

I can see you are frail and sick.  I hope you are not in too much pain.  I wish you peace and I hope your trip home is quick.  I wish you a peaceful, pain free death surrounded by your family.

Dear Patient 

I can’t understand how hard your life is.  I came to like you and your shy manner while you were in hospital.  I know you husband refused to pay your medical treatment, and I am so proud that our mission hospital can provide free care for you.  I pray you have family and friends who are close to you and can support you.  I hope you never feel so bad again as you did that night when you burnt yourself. Please stay well.

Dear Patients

It was nice to see you again.  You lost your papers, but I remember what you went through.  You were so sick, and we really thought you might die.  I was worried when the other surgeon operated on you, as I thought you weren’t strong enough, but he was right.  You healed so well and you put on weight again.  Your husband seems to really worry about you.  I love that he carried the sample from your wound wrapped in a tissue and a plastic bag so that we could see it.  I wonder how long he has kept it safe.  Thank you for healing and thank you for coming back so I could see that you had.

Dear Patients

Thank you for accepting me as your doctor, even though I stumble over my words. I am lucky to have colleagues who look after me, too.  I hope you recognise how important they are in looking after you.  I can’t explain what I mean sometimes (often) but you believe me and trust me.  I will do my best for you, and I worry that is not enough.  Stay well and look after yourselves.

2 responses to “Silent messages”

  1. Pam says:

    I am so so glad you are using your gifts and skills to help others. It must be so hard at times.

  2. ian says:

    Bless you!
    You are a hero to me and I am number 1 fan.

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