On November 15th, 2010, I finally became a Doctor.
..And what a journey it has been. This time last year I sat through the qualification ceremony of my class, and resolved that I would return to medical school and qualify. It has been long and it has been difficult. It has also been punctuated by 20 rounds of chemotherapy, and 9 CT scans. It has involved at times losing my life to study, and at other times losing my sanity to stress. Questions have been made, and with certainty, answered. I have finally run the gauntlet to its completion and survived to tell the tale.
For me, Medicine is more than a vocation, it is an intellectual challenge, it is a passion, but above all, it is the chance to serve humanity when they are at their most weak, their most frail, and their most mortal. The privilege to input into people’s lives during these moments cannot be understated, and with it comes responsibility, respect, and reverence for the human condition.
It was by the Grace of God that I was admitted into medical school, so it is not insignificant that it is by the Grace of God that I get to finish it. Credit lies with God, with Hannah, and with family and friends as I have embarked and endured the journey over the last 6 years.
Having cancer has made the journey more challenging, that goes without saying.
…but also, having cancer has made the journey more rewarding.
It should not be forgotten that it is in light of our suffering, our brokeness, and our trials and tribulations that our accomplishments, our joy and our celebrations become all the more colourful. Life is a vivid theatre of ups and downs, each up is only as monumental as the down that precedes it. It is in light of cancer that I can celebrate this achievement with so much more vigour.
It is in the light of my suffering that my joy shines.
Enjoy the photos of the evening.
I didnt get around to posting after the last round of chemo, so this post can be a dual one for the last two rounds. Generally 12.0 was as similar as the previous rounds have been, everything was well managed and I have been back at work again until round 13.
Round 13 seemed to me to a bit rougher this time. The nausea and fatigue were worse, and hard to manage at times. I still havent vomited yet though which is a good thing. The treatment started off with a few hiccups, the first being that the pre-chemo bloods I had done at Middlemore Hospital ended up being invalid for the trial I am on because their lab isn’t accredited!! So blood had to be taken off me when they accessed my port on Friday. This turned out to be more of a mission than usual, so I had a delayed start to the infusion. Secondly, once the infusion had finished and I was being put on my 46 take home infusion, the pump wasnt working!! So the pharmacists had to ring Baxter, who had to make up a new pump and send it out to the hospital, meaning I didn’g get connected to the pump until 5.30pm friday evening. Friday was a looooong chemo day.
Other than all of that, I’m slowly on the improve and I anticipate being back at the hospital on Wednesday this week as per usual.
I am mega busy at the moment with my General Medical run at Middlemore Hospital. So my blogging is likely to be a little low key over the next few weeks as I spend far too much of my time studying for my long case in 3 weeks time.
‘Till next time….
This week has seen me re-enter the “real world’ so to speak. After more than a year off, I have begun my TI year starting with a GP run out in Botany Downs. The short 2 1/2 days of work was then brought down to earth by round 2 of chemo starting on Friday, and as I type this, I’m slowly to trying to excrete the toxins in my body out, and regain my strength again. I had initially thought I would be back in action midday Tuesday, but I think at this stage beginning back on Wednesday is a more realistic endeavour. This means I will be having 3 days out of every fortnight, which is hopefully workable with the medschool.
The first few days back were interesting. They largely involved the mainstay of General Practice, tonsillitis, skin cancer, lumps, bumps, gout, high cholesterol and blood pressure. There were encounters with snotty nosed kids, and worried mothers, and a guy who had a heart attack and was saved by community CPR. There was the guy who had his aortic nicked during an angioplasty, leading to cardiothoracic surgery, a double bypass, only to have his grafts block up within days of his surgery. The lady with a recent total knee replacement, and the other lady with early onset alzheimers.
Encounters with a broken humanity.
At times, life seems so good, we go along living our lives as we might plan it, clinging to the illusion that we have got what we want, and that we have ourselves sorted. Yet this fragile illusion can collapse around us at a moments breath.
General Practice allows you to engage with the community on a different level than normal, you get to see the brokeness that is shrouded by the lights and glamour of wealth, materialism, and the illusion that we have got it all sorted. You get to see first hand just how fragile our lives are, how quickly they can come tumbling down around us, or even more, how quickly it can come to an abrupt end….
Tired because of chemotherapy….
Tired because I have worked the first 3 days of work in over a year….
Tired because I see that my brokenness is not limited to myself….
Tired because there will always be more questions than answers….
I have just heard the news this evening that a lecturer and excellent physician, Peter Black, from Auckland hospital died suddenly last night whilst mowing his lawns. He was top of his class, and always had us students in awe at his knowledge.
No one is immune, no matter who we think we are, we are not immune from the decay that surrounds us. We suffer ailments as simple as a cough and as lethal as a stroke, and the probability of either striking us seems arbitrary at best, cruel at worst.
Yet in the midst of this darkness, of the slow decline in health and in life, there seems to be hope. Hope for something better than what we have. Sometimes this hope drives us to more illusionary wealth and fortune. Sometimes it drives us to ponder the more introspective aspects to life.
My hope has driven me to serve.
I could wait out the dying days of my life, patient for my last breath. I could feel sorry for myself wondering what I ever did to deserve cancer. I could quietly pass away into the night.
But I can’t.
I have a hope for my life, and for those around me that drives me beyond my own ambition. I genuinely want to spend my life making the lives of others better. Whether its friends in first world, or strangers in the third; whether through being a listening ear, or literally saving a life with my own two hands.
My hope has driven me to serve.
And so, even though I am tired, I am incredibly energised, being back in the work I love to do. Medicine is my calling, and I will follow it. My brokeness tires me, but chosing to serve through it, and in spite of it, enables me to make a difference.
Albeit a small one.
Thanks for Listening.
This is just what i have to have this morning, excluding my clexane injection at 9am, and further tablets pre lunch, pre dinner, post dinner, and pre bed. About 25 plus tablets all up for the day.
A meal in itself really 🙂
I thought i would do a quick post giving a run down on the drugs that I’m currently on. The first on the list is the main event.
Capecitabine is the drug that i have to take 4 tablets (2gm) twice a day every 12 hours. This is a 5-flurouracil prodrug. The prodrug part means it gets metabolised into the active parts of the drug at the location of action, the idea being that it reduces the overall side effects. 5-FU is a DNA base analogue that gets incorporated into the DNA of rapidly dividing cells (namely the cancer cells) and then prevents them from dividing and growing further. This stuff is so toxic that 5 have to wash my hands after handling the the tablets.
Loperimide is the next drug in the lineup. This is essentially just an anti-diarrhoea drug, one of the main side-effects of Capecitabine.
Ondansatron is one of the best, and most expensive anti-emetics around, so much so that I can only get a script for this bad boy for no more than 6 a month.. so I have to use is sparingly……
Domperidone is another anti-emetic, that i take 2 tabs of 4 times a day, usually half an hour before each meal, then before bed.
Dexamethasone is a really really potent steroid, and will make me fat fast if I’m not careful. Its also a really really good anti-emetic, although its mechanism of action isn’t really known. They just know it works really well. This one is 2 tabs per day after breakfast.
And Finally, Paracetamol is just a good run-of-the-mill drug, it makes me sleep better at night, and helps with all the aches and pains the come with cramping all the time with the Capecitabine.
So there was a quick rundown on what Chemo involves. And don’t forget the 2 hour infusion of Oxaliplatin that I get at the beginning as well.