Challenges to compassion

Whenever I put in more hours at clinic, like this week, I am challenged to remain compassionate in the midst of medical 'problems'. Not every patient -in fact most are not very sick.......and thankfully have acute self limiting illnesses. But the few who are ill can pose a challenge to compassionate care. This is because medicine is never just technological and curative as we deal with frail humans, not machines. People have many emotional and spiritual (although this they may not even be aware of) baggages that go along with the physical ailment.

I saw an elderly woman who had had part of her foot amputated for diabetic gangrene. Her son brought her - and he was loudly scolding her (she is hard of hearing) for not allowing the hospital doctors to amputate the leg further up, as they recommended. In her fear of the loss she refused to sign the consent and only a part of her foot - two toes were amputated. I removed the bandage - and there was the wound looking unhealthy and smelling strongly of dead (necrotic) tissue. I tried to get her to understand why a higher amputation has to be done (explaining in my poor Cantonese the technical stuff about the tissue being dead further down because of poor blood supply and not able to heal etc )......while she on her part begged me (with hands clasped together...) to please do something to save her foot. At last her son scolded her and told her in no uncertain terms that she would die if the leg was not amputated.......I guess I played my role (as expected by the son) to advise her to cooperate with the amputation, as he was going to take her back to hospital. For the woman she may have hoped against hope that I could perform the miracle cure and make the wound heal. At such times perhaps the real healing (as opposed to cure) she needs is caring compassionate presence......rather than family members who are too stressed and worried to be of much help or doctors who need to play a certain medical role.

I don't meet such patients often, but even the occasional encounter leaves a feeling of sadness and helplessness. I could imagine the elderly woman's fear of the anticipated loss - of mobility, of a body part, of who she is......(one of the things she said was...."at my age how could I live with my leg cut off?" ) Much of the time, doctors have to go on as 'normal', yet, when such a stance is taken for many years, we may lose a part of ourselves - that of being human and vulnerable. I was thankful that the clinic was not really busy and I could sit with my feelings for a while. O God, have mercy on all of us, for we need You, even those who don't know that they do. Amen.