Sunday, February 10, 2008

Oh God, I'm So Sorry !

It's been more than a week now. It keeps lingering in my mind, and though i've tried to forget it, the memories keep coming. honestly, i just couldn't come to term with the fact that i've lost her. in Almighty Allah i place my trust.

she saw me a few weeks earlier complaining of increasing forgetfulness, persistent frontal headache and progressive blurring of vision. and of course i didn't take her words for granted when she told me that she was suffering from migraine. it came as no surprise when the magnetic resonant scans of the brain indicated a large broad based tumor over the fronto-basal region. there was also severe papillodema from compression of the optic nerve causing her to have impaired vision. the options were clear, surgery to remove the tumor or she'll gradually suffers until her time is up, perhaps in a couple or months or within the next 1 or 2 years at the most. somehow, deep inside me, i've some reservation - the uncomfortable feeling i sensed creeping in me. the feeling that i could not really expressed. not that i've never seen such a tumor - in fact i've operated on far bigger and worse tumors than this.

the 8 hours long surgery went fine, the blood lost was minimal and her vital signs were stable throughout. under operative microscope guidance, the tumor was removed piecemeal till the last bits. despite a bit exhaused, i felt a sensed of deep satisfaction knowing that the tumor was completely removed. hourly monitoring of her vital signs and pupil sizes were normal until disaster stroke at 8.00 am on the following morning. for reasons i found difficult to comprehend, her blood pressure suddenly dropped and within 20 minutes, both pupils were fixed and dilated. oh my god ! this can't be true .... I've just lost her. Why ??. no, it can't be that sudden !. of course i was worried about acute hemorrhage in the brain but then a repeat CT scan of the brain done soon after indicated no such hemorrhage. her deterioration was very rapid and within hours, she was demeed brain dead. my God, she does not succumed as a result of the surgery but to something else that was so acute and unexpected.

the next 2 days was indeed very stressful and full of despair. i just can't help feeling so sorry for her family and friends. i was really feeling very down and decided to cancel all my appointments. and i felt sorry for my receptionist anna as she had to deal with the dissatisfied and frustrated patients some of whom travelled all the way from johore bahru. my biggest doubt has always been when to terminate the ventilation when one is clinically brain dead. following our discussion with the family members and a renown ustaz we finally decided to let her go. her heart stopped beating approximately 40 minutes after withdrawal of the life support machine. Al-Fathihah. May Allah rest her in peace and make her abode in Jannah. according to the ustaz, based on the medical grounds (when the patient is pronounce brain dead and her condition is not compatible with life anymore as confirmed by a qualified muslim doctor) and hukum fekah it's a must for one to terminate any form of life support so as not to prolong the sufferings.

it was rather unfortunate that her death still remain a mistery. if only her family members have consented to a post mortem, then perhaps we could get to know the cause. but on second thought, was it really necessary. as a believer, i truly belief that Almighty Allah knows best !. and whenever i lost a patient, i would be suffering from a feeling of desperation and low self esteem...and i know this is going to last for weeks. how i wish i could turn back the clock and embark on a less stressful profession ........