What’s the worst that could happen to you?

Do not be afraid of anything. As long as you’re not incapacitated then you can facing anything head on is what my very good friend said to me a day ago over the long phone call we had.

I felt that.

A while back, during one of our neurology tutorials, we presented a patient with a cerebrovascular accident. She was ostensibly immobilized and most of her basic functions diminished for instance she could neither walk nor feed herself leave alone turn sides if sleeping on one side hurt. My heart bled for her. When you’re so used to conducting your daily activities on your own that you cannot fathom helplessness which is practically each and every one of us, then a stroke hits you hard and in all the wrong places. I kept wondering, where do their minds wander to the whole time they lie there helpless? Could it be that they do try to talk only to have to words or no vocal muscles coordination result in frustration we’re oblivious of? What happens to your will to live when you lie there, a vegetable, unable to perform a task as simple as hold a cup? What keeps these people going?

You cannot dare to wish to be incapacitated. It’s a living nightmare, literally.

I had called my friend and went on the ubiquitous rant about exams being exams when she told me this. It got to me because we very much take for granted the automated things that our body does like breathing, walking, smiling, defecating, urinating. Can you imagine what it would be like if from this moment you were unable to defecate? Say you woke up and as usual went to the toilet and you waited unsuccessfully, then you tried exerting force thinking that perhaps you’re constipated again, unsuccessfully. You put on your pants and make a mental note to try defecating again later, perhaps tomorrow after you’ve hydrated. Tomorrow morning dawns and you can feel your abdomen distending and a feeling of uneasiness is settling in because you don’t joke with food! You’re quite the enthusiastic eater. This time you stay in the toilet for a whole 20 mins trying to push your intestinal content out in vain. You get concerned but since you’re bashed about being unable to do something as natural as defecate, you put off your visit to the doctor and make a mental note to try defecate again over lunch at work. Which of course, fails again.

Two people I know recently has facial nerve palsy. These full of smiles people, suddenly, had blank faces. It can be and it is a traumatizing experience. To be unable to keep food in your mouth and instead have it slip out of your mouth as you watch! To find yourself drool like a baby with cerebral palsy. Are you taking your ability to smile for granted?

What would you do if you could not walk? If suddenly your left leg cannot simply step in front of the right and you have to literally drag it along with your hands. It’s scary, isn’t it? So, after a lot of deep thinking about what my friend told me, I realized that it is true. As long as you’re not incapacitated, you can face anything head on.

So stop fretting and making excuses and be grateful that your diaphragm can move in response to inspiration and expiration without leaving you gasping for air in despair.

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Can you cheat death?

Have you ever been the bearer of bad news? No, terrible news?

Are you one of those shoot the messenger kind of persons? Well, then imagine how hard it is for the bearer of the news especially when the message is life changing. Tell me, how do you look at a terminally ill patients’ family and deliver the news when they ask you, “Daktari, kwa nini hii ugonjwa haiponi na amekuwa akishinda hospitali?” Tell me, do you go have a glass of water first, wipe and imaginary beard of sweat from your forehead or do you rehearse in from on the mirror first putting on you most grave facial expression just to gain the confidence to deliver the news and an empathetic expression to comfort them? What do you do when the mother breaks into a wail and starts tugging at her shawl and her hands quickly find the back of her head as she calls the names of her ancestors? Do you stand there awkwardly and ask them whether they have any more questions or clarification or do you silently weep with them? One doctor once told me that contrary to popular belief, one never gets used to death. Not even morgue attendants. Not even brushing shoulders with loss hardens you enough to eliminate the despair and exasperation that comes with losing a life, even worse, a loved one. If you’re a doctor you sleep wondering what could have been done differently or what could hare been detected early enough to evade the tragedy.

It changes you.

And what about the patient? Do you tell them that you only live once could never hit closer to home? Or do you stare at their eager, expectant eyes, bite the inside of your tongue and utter I’m sorry then follow it up with the dreaded but?

Isn’t it dreadful? To be the one to let a human being know that there’s no further hope for them save for enjoying the taste of air while their lungs can still allow them?

Which reminds of one of my favorite books that has a similar storyline and moved me tears and desperation where the author, Paul Kalanithi says that “Even if I’m dying, until I actually die, I’m still living. “