Anyway, back to the patient at the next bed. He had a grossly distended abdomen.
“Good evening” I greeted him.
“Good evening” he replied with a smile.
The usual handshake and brief introduction took place. Let’s call him Mr YYY.
“I know, I looked like a pregnant lady, right?” he joked. When patients start throwing remarks like that, I tried to be all serious and professional. Holding his wife’s hand, he continued, “After she gave me 2 smart sons and 2 lovely daughters, it is about time I return a favour” he tempted a laugher from me, waited for it. I managed half a giggle. I thought that was a very sweet thing to say to his wife.
From that shiny skin, we could have easily made a safe guess – gross ascites. The differentials start popping out, like pop-corns in the oven. He slowly unfolds his story. He had End Stage Renal Failure. In simple terms, his kidneys could no longer function normally and sustain his body needs. Or in more simple terms, he needed dialysis (or a renal transplant) to prolong life. I offered to explain the nature of his illness to him, but it seemed that he already had a very good insight of it, a very educated person, I supposed.
It is not very often that we see such loving old couples around the hospital. There’s always the husband who complains non-stop, dominating, or otherwise very promiscuous. And the wife who nags, could not be bother, wearing a sulky face all day, otherwise very hot-tempered, peri-menopausal stage, we labeled them. So, it is really nice, seeing old happy couples every once in a while. Further clerking revealed otherwise though.
It seemed that all their four children were very highly educated, overseas education- he said. Lawyer, engineer, successful careers… He must have spent so much on their education. I’m just glad to see him so proud of them.
“Which children are you staying with?” I innocently made an assumption.
“It is just the two of us” He replied, looking back at his wife.
I put down my pen and clerking sheets. The somewhat formal clerking evolved into a casual chit-chat. He started sharing his stories about his life, his opinions. Mrs YYY would continue with their sweet loving stories. They were very friendly people.
I later found out that all his children had migrated to Australia. They meet each other only once a year. Hardly.
“Do you miss them?” I accidentally blurted out. I was not sure whether as a med student, I was actually allowed that question. But I guess, I asked more as a friend.
“Sometimes” he answered “I tried not to miss them too much”. His eyes revealing the sadness in him “Luckily I have this beautiful lady to take care of an old hag like me” he held his tears back and took his wife’s hand again, and she was blushing like a little child. "You are indeed one lucky man" =)
He was a pleasant person, his eyes lighting up when he gets excited, dimmed when otherwise. If you may be wondering, his wife was not one of those drop-dead-gorgeous auntie which one might wonder in awe, - how does she keep it? No. She was somewhat ordinary, perhaps almost too plain. She might even passed as a cosmetic model for a product saying [use this if you do not want to end up like her in 10 years time], no offence. Thick wrinkles formed at the end of her eyes, skin not spared from the harshness of time, body stretched from all those child births. But in the eyes of her husband, she is perhaps the most beautiful women on Earth. And if you attempt to look close enough though, you can see that she must have been a jewel during her younger days.
“Why not follow them to Australia?” I asked another dumb question, almost like a reflex.
I paused a while and allowed him to break the silence.
“Well you see, I have End Stage Renal Failure” he answered, which explains everything.
Right – Dialysis 3 times a week = $$$
The painful reality is not very hard to translate.
“I just wished I would not go early. I would not want Mrs YYY to be alone”
My teachers used to say, you learn the most from your patients. I believed that this is very true indeed. We learnt not only about illness, diseases, diagnosis-investigations-managements, we learnt not only what is expected of the medical school syllabus, to pass exams; but we learnt something perhaps of even greater importance; some things that we would never find in our textbooks. We learnt about Life.
Sometimes, in search of a better life, for the sake of our children, our grandchildren, are we forgetting people who matter used to matter to us?
Health is perhaps THE MOST EXPENSIVE commodity in the world!
Behind those smiles, lies a sad story.