Louisville Medicine Volume 67, Issue 3 | Page 10

REFLECTIONS REFLECTIONS: THE THINGS WE DID AUTHOR Teresita Bacani-Oropilla, MD “It isn’t the thing you do, dear; It’s the thing you leave undone, Which gives you a bit of heartache At the setting of the sun.” -From “Sins of Omission” A by Margaret Sangster t the sunset of our lives, we tend to look back at our past – an examina- tion of conscience – a panoramic view of what we have done with our profession that changed the lives of our patients and their families and communities. It is obvious that the longer one lives, the more varied the circumstances, the greater the opportunity to use one’s training and skills, either stat or PRN (pro re nata), to “help humanity” as one had vowed. Each medical professional of whatever persuasion has special memories that need only the slightest nudge to provoke retelling to willing listeners: 1960, rural Philippines, an unconscious adult male in a hammock was rushed by jeep to my pediatric clinic. He was suffering from Cholera EL TOR that had caused many deaths in the surrounding countryside. A quick ankle cut-down to his vein and hand-pushed IV fluids restored circulation, revived him and soon after he returned to his former life. An eight-year-old girl fetching drinking water from a mountain stream had not been able to go to school because of festering drain- ing nodes on her neck. We gave her an ample supply of Isoniazid, cured tuberculous lymphadenitis and made her a happy camper the next school year. She grew up to be a contributing member of the community. Louisville 1975. A supposedly smart, healthy 15-year-old ad- olescent could not read nor follow instructions. He got lost when sent on errands in the little town where he grew up. He was taught orientation by placing a ring on his left finger and learning that any part of his body or anything else on that side was “left.” Then, things began to make sense. Now he could follow arrows to the left or right and not get lost. He could distinguish the subtleties of letters like small “b” versus small “d” and learned to read. Four years later, he surprised his doctor and teachers by showing off the bright new pickup truck he had bought. He had become a welder, had a 8 LOUISVILLE MEDICINE girlfriend and was on his way to successful adulthood! A contemporary pair of twins couldn’t be kept in regular school because they shouted verbal obscenities without provocation. Georg- es Gilles de la Tourette Syndrome (described by the French neurolo- gist in 1885) was ameliorated by medication and behavioral means. Having previously dealt for 15 years with malnourished chil- dren with helminthiasis, TB, diarrhea, malaria and other ailments considered exotic in our modern immaculate hospitals, it was dis- concerting to see a young boy regularly swallowing pins that needed to be removed by bronchoscopy, a 13-year-old overdosing with insulin, a boy breaking his leg the day after discharge for a healed broken arm. I undertook a psychiatric residency to understand such self-destructive aberrations. Additionally, in the 1980s, we needed physicians to help treat suffering dysfunctional families after fathers and sons came back from combat duty with post traumatic stress disorder. That, and the aging veterans with other ailments, offered new challenges. A little distraction arose when a fiftyish-year-old man came with complaints of poor memory, no longer enjoying family activities, and general fatigue. He was hoarse, had dry skin and puffy eyelids and moved ever so slowly. A classic case of hypothyroidism, then seldom seen, he was eagerly investigated by medical residents and students who managed to see him before he was successfully treated. Thus, the years roll by, each person having their own remark- able stories. Now in my ninth decade of life, having spent 63 years doctoring, I can attest it was replete with life, love, pathos and strength of spirit. “For the things we did, dear, To the best of our capabilities, Were to sooth the heart aches Until the setting of our suns.” Dr. Bacani-Oropilla is a retired psychiatrist.