Saving life while dying

Column-Dr Saturnino Javier photoPrime Angle

Saturnino P. Javier, MD, FPCP, FPCC, FACC

IN THE LATTER PART of June this year, I referred a patient of mine in a tertiary hospital in the South to a heart rhythm specialist and his trusted physician partner. The patient was an octogenarian female who needed a permanent pacemaker based on a preliminary clinical impression of life-threatening heart rhythm abnormality.

While awaiting schedule for the pacemaker implantation, the trusted partner did his rounds. Alas, while doing his rounds, the patient went into seizures because of a dangerous and fatal cardiac rhythm irregularity which manifested right while he was in front of her.

Acting with dispatch, he brought the patient to the appropriate hospital unit for temporary pacemaker implantation. A few days later, the patient eventually received the permanent pacemaker, transferred out of ICU and discharged in stable condition. She had later followed up after a week or two. She was doing excellent.

Much later when she followed up again, she was noticeably much improved. Quite ironically, the doctor, who saved her life, had died – less than two months after saving hers. The cause of illness was far advanced cancer.

All of 40 years, this colleague of mine, unknown to me and many others, had been harboring a self-diagnosed malignancy. He knew he had very limited time to live. He was aware he would succumb soon. And he planned for his exit in the clearest manner possible – his own terms. From the condominium he occupied for years, he moved to his parents abode and decided to stay with them and his siblings for the rest of his remaining days. He imposed a no-visitor’s policy except for two dear mentors who must have begged endlessly to please allow them to see him, touch him, and reassure him. He did not seek further treatment. He did not want to be hospitalized. No respirators. No nasogastric tubes. No chemotherapy. No life support systems. Just his family and himself – and his Faith.

Quite a religious devotee, who regularly received the Holy Eucharist everyday in the hospital during the regular noon mass, he devoted his remaining time to be with his family. Yet, he would not pass on the chance to save another life – that of a patient of mine.

Three days after he saved my patient’s life, he disappeared from the hospital. He made a sudden leave of absence from hospital commitments and medical responsibilities, embraced the solitude of home and the warmth of family togetherness. His sudden absence triggered an avalanche of why’s, what’s, and how come’s. I can only smile in amusement at the genuine concern that filled the air. I can only mumble quietly to myself – let us respect his wishes, let us give him his space.

He must have become too weak to do the final closing sutures on this patient of mine that when his partner mentor offered to do the last few stitches, he readily obliged. I would imagine that in his days of vigor and strength, he would not let such a menial task be done by his mentor.

In the end, he must have wanted to leave everyone with the indelible images of a laughing, joking and heckling friend and colleague. He must have wanted to spare everyone the agony of watching him go. He must have wished to disallow any opportunity for pity.

What can be nobler than continuing on to embrace the calling of a profession that mandates one to heal and save lives, when one is fully aware that the life he is sustaining for someone else, is the same life that he slowly loses grip on? What can be more selfless than making someone else breathe when you yourself are running short of it? Can anything be more genuinely Christian?

Dr. Von Meldrick Gonda, one of the country’s top electrophysiologists, succumbed to cancer on August 22. To my knowledge, the last life-saving procedure he performed was on a patient of mine. Thus, I could not get over the irony and the tragedy.

I could only surmise that this was a divinely designed opportunity before he was granted eternal peace. Or that this was a final call of duty that he sought to respond to before signing off with his Hippocratic calling. Or that this was really second nature to the kind of committed and involved clinician that he was. And that this was his ultimate passport to heaven. (Yet to many who knew him, he was already guaranteed indefinite stay in His Kingdom)

So long, Von. Sleep in Thy Holy embrace.

VitalSigns Issue 68 Vol. 3, October 1-31, 2014

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