I don't know why I decided it would be day 17 ... all the days were all a blur for the two years I worked in this parochial little town in the middle of almost nowhere, over two hours drive from what I still then considered to be my home.
Seventeen just sprang to mind ... and I have discovered that the number 17 is an important number.
Seventeen is comprised of the digits 1 and 7.
Seventeen is a prime number. It is the sum of all the first four prime numbers.
Seventeen is the maximum number of strokes in a Chinese radical.
Seventeen is the number of syllables in a traditional Japanese Haiku.
The number 17 is considered to be unlucky in Italy.
Despite this, the number 17 was chosen for no particular reason other than it seemed about right. Representative of the further anecdotal ramblings that spill from the rush of my first two years as a doctor.
Mid December that first year, my mother died. Yes, I mentioned this but I feel the need to elaborate. My mother's death and the events leading up to it were as sobering lessons in being a doctor as my intensive time in hospital.
Lets roll back time a little ... four years earlier to be precise. My mother had a routine Pap smear test (as all women are encouraged to do) and the report on this test indicated cancerous cells developing. She was advised to have a hysterectomy and dutifully she allowed this to be done. The pathology test results after the operation indicated the complete absence of any cancerous cells. Being firmly religious, my family took this as a miracle. I was not convinced. My first thought was that the first test was wrong, but being a medical student in the great place of learning that my mother was being treated, I felt I was not in a position to question the authority of the gods of the place. The stress of the operation triggered an elevation of my mother's blood sugar that was diagnosed as diabetes, and with great aplomb the resident doctors of the hospital started her on insulin injections and discharged her home. Mum struggled with her injections and eventually (with a little inside knowledge from our training in another place) we arranged for her to see a diabetes specialist who weaned her off all medication and her "diabetes" was eventually controlled with diet and tablet medication.
First do no harm.
During the first year I was working in the hospital, my mother started to experience transient dizzy spells that she managed to hide from us for quite some time. Eventually the symptoms became so significant and worrying to her she sought medical advice. Her doctor investigated these symptoms and discovered that the main arteries in her neck that supply blood to the brain were severely narrowed and were likely to be the cause of her symptoms. Without treatment there was an accumulating risk over time that my mother would have had a stroke. My mother never feared death, but it was her greatest fear to become invalid and totally dependent on others for her care. She did not want to have a stroke. Having been advised that vascular surgery was necessary my mother was admitted to hospital for the procedure of carotid endarterectomy ... the purpose being to remove the narrowing and reduce the future risk of her having a stroke. One other patient was on that operating list for the same operation.
Both that patient and my mother woke after their operations to discover that they could not move one side of their body. The other patient fully recovered within a few hours, my mother never did. She lost fully her ability to speak and had a paralysis of one side of her body. My mother stayed in the acute care ward for two weeks and was then transferred across to a rehabilitation ward. Within 24 hours of her arrival in that ward, my mother suffered a heart attack and within another 24 hours she was dead. I knew in my heart that when my mother saw the other severely disabled patients in the rehab ward she decided she was not going to allow herself to live as she feared, totally dependent on the care of others. She gave up her will to live.
First do no harm.
One resident doctor covered the hospital that weekend so my wife and I could come back home to my mother's funeral. I don't even remember who that resident was. That makes me sad.
Christmas that year was also very saddening. My mother was well organised and had prepared gifts for the family in advance. Opening those gifts without her being present was a profoundly emotional time for us all. My mother had also left her secret diary for us ... she must have known the risk of the operation and had prepared for the eventuality of an unpleasant outcome. I will speak of the rest of the blur another time.
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