Friday, February 22, 2008

This memorial service is unique in that it is so much more.

"You'll never see this again in your career," the anatomy prof warned us.

This week's anatomy lab, our last, was a particularly unsettling one for me.

Even though we have done a number of dissections of every part of the body, most of them have retained the semblance of normal anatomy - while we've dissected the entire abdomen and thorax and arms and legs, we haven't removed limbs or anything.

So when the anatomy professors showed us an incredible way to visualize the neck components from the back of the mouth to visualize the epiglottis, trachea, larynx, and then demonstrated the technique, I had a bit of trouble watching.

That's because the dissection technique, shown to us by the anatomy instructor on the demonstration cadaver, involved dissecting through the back of the neck... to the point where the heads of our cadavers were rolled forward and almost entirely removed from the bodies.

It was true - the technique provide a fantastic way to understand the anatomy, and I learned a lot from it.

But seeing a person's body with the head nearly removed, even though I have seen them dissected in every other region, was just a bit much. I was reminded again about how these "specimens" are actually human beings who at one point cared about us and our future patients enough to donate their bodies to our anatomy program.

I don't get the chance to thank the people our cadavers once were, and sometimes I wish I could. But because I can't, I decided to post a speech I gave at the memorial service our school held for the families of the body donors...a tribute of gratefulness, in memoriam.

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Welcome, medical faculty, the students of medicine, dentistry and rehabilitation sciences; and most of all, we would like to extend the warmest welcome and deepest gratitude to the families of those in whose memories we gather. Thank you for coming.

My name is Vitum Medicinus, and I'm a representative of the second-year medical class. I've been asked to welcome you here and to convey the feelings, experiences and, most of all, the appreciation of the students who have the incredible privilege of learning anatomy in the best way possible thanks to the incredible gift your loved ones have given us, through the anatomy program at our medical school.

This ceremony is a unique one. Many memorial services focus on celebrating the life of the individual being remembered. In that sense, this service is no different.

But this one is unique in that it is much more than that - it is a service of admiration and gratitude, in memoriam of those who have given so much of themselves, and in doing so, have taught us so much about the intricacies of science, using so few words.

Every student in these faculties would tell you that no textbook could ever equip us to understand and aid our patients in the way the donors have. The anatomy program is an educational privilege that none of us could ever take for granted.

And yet, beyond the lessons of science, through their actions the donors have taught us many more lessons.

For example, they have taught us about bravery. Thinking ahead to one's own final moments is not always a comfortable thing to do.

And they have taught us about selflessness and altruism. They have given as much of themselves as they could, to ensure that we, as tomorrow’s health care practitioners, will have the best possible preparation for tending to those who need our help.

Through their generosity, the donors have indeed set a high standard for us, in demonstrating the qualities that we future dentists, doctors, and therapists, should all hold dear when we treat of our future patients.

And so we thank them, and wish we could share with them, tell them how much we appreciate their decision.

While they have taught us so much with so few words, it would take all the words in the world for us to begin to show them our thankfulness, which is what we will try to begin to do today.

The students you see here have put together this service in its entirety in an effort to show our respect and appreciation, and in memoriam of the contributions of these generous individuals.

All parts of this service - the candlelight procession, readings and musical performances, are dedicated to the memory of those whom we have come to pay our respects and gratitude to today.

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Tuesday, February 05, 2008

"The chemotherapy hasn't helped yet, but I can beat this."

In yet another assignment to hone my interviewing skills, I found myself on a hospital ward this week asking a charming patient about her medical conditions. Though it wasn't what had brought her to the hospital this time around, I soon found out this fairly young lady was battling pancreatic cancer, and could no longer work due to the severity of her condition.

"I come in twice a week for my chemotherapy. It hasn't really helped yet, but I don't think I've been on it long enough for it to start curing the tumor," she said, fidgeting with the Natural Cures for Cancer book on her lap. "I'm pretty optimistic that I can beat this."

I was inspired by the patient's courage. Given her dismal condition, it was nice to see there was a ray of hope promised by the treatment.

Before I presented the patient's story to my preceptor, I obtained some collateral information from the chart as I had been asked. From what I read there, however, any ray of my hope in my mind quickly dimmed.


I'd had a feeling during the interview that something wasn't quite right. While I'm not a doctor yet, let alone an oncologist, I do know that pancreatic cancer is pretty serious. But, I had taken her on her word that there was an encouraging outlook. Perhaps her type of pancreatic cancer responds well to chemo, I thought.

What I found in her chart confirmed my initial suspicions:

"Patient has Stage IV advanced pancreatic adenocarcinoma, receiving palliative chemotherapy."

Though palliative chemotherapy can help with the pain and other symptoms of cancer, it's not provided with the intention of "curing the tumor."

Maybe nobody ever fully explained to her the role of palliative chemotherapy. Worse yet - heaven forbid - maybe she hadn't even been told that her therapy was palliative.

But the situation probably wasn't either of those. Because right after that, the physician had written,

"Patient is in denial with regards to her condition, despite numerous discussions regarding prognosis."

When I discussed the case with the doctor, he explained it to me another way. "Barring a miracle, the flowers in her room will last longer than she will."

I still wonder if I should've gone back to her room to say goodbye.

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