Monday, January 20, 2014

Dealing With Loss. Survivor's guilt.

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This Is Tragic.

Bree and her friend Bridgette were diagnosed with leukemia, on the same day, at the same hospital. They underwent painful, grueling treatment together. They spent the hardest times of their young lives with each-other...

And now that Bridgette's died, Bree can't imagine living without her...

It speak volumes on our ability to love...
And how love's power can even outweigh our ingrained instinct to endure.
It's tragic...

But this kind of loss happens every day. And not just to cancer patients like her and I.

I felt a loss similar to hers not too long ago. The loss of my first patient.

To be fair, I'm not a doctor, yet. After my experiences as a cancer patient though, my drive to wanna become a doctor - a dream of mine from childhood - only grew stronger. Hugely. But on occasion, I meet people, either through this blog, from a friend, or at hospital, who are going through hard times. Through my experiences, I try and help them by giving them encouragement, someone to talk to, and, in the case of other cancer patients, who, I guess, make up the majority of people I talk to, trying to inform them of what's to come (all the while trying to get them to be happy, despite what could be a long, hard battle).

Before my first bone transplant, I found that having the words of someone who's been through the process more powerful than those of my doctors. They just stuck, there was just more power and credibility to the words that came out of a fellow patients’ mouth. And about midway through last year, I met a patient who was about to undergo a BMT. He'd been going strong for years after his lymphoma was in remission, but it had come back, and this was his last option.

A nurse responsible for coordinating the transplant asked if I could tell him about the procedure. I started talking to him and giving him tips for the procedure. I comforted, consoled and encouraged him when he got scared.I even prayed with his crying family at one point... and continued doing that through the whole transplant procedure, where I could.

I can still remember his eyes on the eve of his discharge from hospital.

I'd told him of all the things he had to look out for after the transplant - the possible fevers, rashes, diarrhoea and fatigue, amongst other things. I gave him tips on the recovery process, and assured him that he could do it.

I still remember the laughter of him and his family as I left his room.

Despite his shaking, despite his pain, despite the suffering, his eyes were filled with hope for the future. Hope that he could, and almost would be normal again.

That was the last time I saw him...
He died a few weeks later.

He wasn't old - he was in his 20s, only a few years older than me.

He'd only started living.


When I found out, I was shocked. He was suffering, he wasn't done with treatments yet. I knew that and he knew that too. But he'd seemed so positive, so sure he'd make it, and the doctors thought so too… but he didn't.

After that shock, I started asking myself unanswerable questions.
What had he done to deserve this?
What would happen to his baby?
Why him and not me?

I was feeling the same thing Bree had after Bridgette died... the pain of sheer and utter loss... the pain of losing someone so close to me.

The next few weeks, I couldn't bring myself to do anything. I didn't wanna read, write, talk to people. All I did, day in and day out was browse pointlessly through the internet, not even registering what I was doing...

It was only later on that I realised, that I was told, that I was going through depression.

Frank's death was a major cause of it, but the frustration of the ongoing treatment and the medications I was on, all contributed to my feeling down... out... and empty.

I could see that something was wrong… I didn't want it to stay that way. 

But it was JUST SO HARD to even break the pattern of doing nothing and not caring.
Especially after the world seemed so meaningless, so unfair, after all this.

After a while… when I could bring myself to do it I sat down and asked myself, what next?

It was then that I remembered my own blog post about depression. I looked over that post again. And I took my own advice.

I talked to somebody about it.

That somebody, for me, was Dad.

I told him how I was feeling, and he listened. He didn't know about Frank's death, didn't know about the loss I was going through. But he gave me another perspective of looking at things... and that would mean the world to me.

Me, I was trying my best to help people. And that's not a bad thing to want to do.

But he made me see that I was overdoing it - I was giving up my own happiness, sleep and even food only months after my second transplant, a critical stage of my health.

I was staying up late, talking people through their problems, writing too much too often and pushing myself harder than I should've been.

He assured me that I would help more people in the long run through my being a doctor, if I first helped myself. I agreed. 
He also convinced me that I'd help others in the short term if I did that too. I couldn't write or study medicine if I was stuck in hospital for the next few years, right?

And that helped me see that I couldn't hurt myself anymore over Frank's death.

A different perspective was all it took...

But the question still remained. 

How could I get over the loss?

This time I loved back to how I used my mind to beat my cancer and again took my own advice.

I asked myself why.

Why was I was feeling that way...

After a while of soul searching, I saw it was exactly what that poor girl was going through. Survivor's Guilt

The feeling of regret after you lose a loved one. It's the same regret when you fail at something at life. Regret that you hadn't done enough, hadn't been there enough. It only adds to the melancholy that is loss.
But why was I punishing myself that way, instead of asking what Frank would have wanted for me?
In the end… I knew that he would want me to be happy. To do him proud.
Why shouldn’t I do that instead?

Why was I blaming myself for Frank's death.
I thought I'd given him hope. And then stolen it from him…
Why hadn't I done more?

That was what was eating me.
On top of the loss of a good friend.

But after a while of asking myself why again, I realised that I had told him of all the risks, of all the pain that comes during and after a bone marrow transplant. I told him he wasn't done yet - that the recovery process takes years for some.

All I'd done was give him advice for getting through the procedure and speeding up his rehabilitation. And someone to talk to. And someone to visit him, laugh with him, someone to give his brothers and wife a shoulder to lean on when they needed it.

Yeah, he died young, and yeah the last few weeks were filled with struggle. But there was no way I could have stopped that. He'd been unlucky to even get the disease in the first place, yet alone get one the chemo and a transplant couldn't fix.

That reminded me of a quote from M.A.S.H. 

"Rule number 1 of war [or medicine, or life], young men die. 
Rule number 2, doctors [, no-one] can't change rule number 1."

All I'd done was give him some happy moments in the last days of his life.
I'd done all I could do.

That guilt I was feeling was only harming me. Something Frank would never have wanted for me.
And realising that allowed me to let that pain go…  

But I didn’t want it to end that way.

The loss of this still stuck. The feeling that this was all unfair was still there… But… sad as that was, I couldn’t change that… Sowhy was I only focusing on that?

The best way I could honour his life, and let him live on, past his time, I realized, was to learn from my experience with him and help others get through what I went through. To help others get past their losses and failure. To help others turn the pain and anguish that comes with it into something that can help them, and help others in life.

That's what this post is about.


·                     He reminded me that no-one can live forever, that no-one always wins in life.

·                     That when we lose someone or something we care about, we will miss them.
But once we get past our grief and failure, we have a choice on how we deal with it.

·         That his personality. His spirit.  His impact on this world… Still lived on, beyond past his time, by how he’d changed those around him. By how his amazing family gathered around to help each-other. By how he could laugh in the face of much pain…

·                     That we can either dwell on the past and close ourselves off to others and to opportunities... 

Or we can learn from them, from the mistakes we've made on our journey with someone or to something, and use that to not only get over our loss, but also to improve ourselves.

That way we can be more successful, influential and HAPPY human beings.
Ones our loved ones would be proud of.

It won't happen in a day. We may have to do some soul searching to get there. And if we can't see any other way of looking at it, talk to somebody about it. 

I hope my experience with Frank can help you see your way around your losses.
When you lose someone close to you - a friend, a family member, your mother, your father, your son - you will feel loss, and you will feel pain. 

Frank was a close friend. He’ll always be a part of me. I can only imagine how hard it would be to lose a brother, partner or child to this disease…

But after a while, YOU have the choice on how to remember them.
So LEARN from those you've lost. Let their time on this Earth, let their qualities, their words, their philosophies, or their tragedy, inspire you to be a better person.

They live through you if they've taught you how to live.
They smile on as you smile and make them proud. 

Always remember that.

What does that mean for me as a med student?
I've learnt that I can't save everyone... 
I'm only human... people live and die and no doctor or scientist, can change that.

I've learnt that I need to take care of myself before I can help others. I need to make sure I get better first, that I don't overstress myself (especially now, while I'm still recovering) and when I become a doctor, that I don't blame myself for deaths or misfortune I could not prevent.

But does that mean that I, like many doctors, close myself off to others and never get close to patients?

I'm not a person who can or wants to do that... And I'm not going to turn to alcohol, or other drugs, to get over the sadness my profession entails either. Alcohol abuse is surprisingly high amongst doctors, despite their better knowledge, for a reason...

What I will do is remember this story, and remember what I've learnt from it.

I will still care for others, I will still connect with my patients, I will ALWAYS try my best to help them in their times of need.

But when I lose someone, when I miss out on a promotion or fail and exam, when I just feel down and out... I will talk to someone. 

And I WILL get over it. 

A talk I gave, on this issue and on the horrible stereotype and expectation cancer patients are expected to live by (read about that here:) 

If you or a loved one is facing loss or depression of any kind, you can always get over it. It won't happen straight away, it will take time. But talk to someone about it. Talk to a friend, a loved one, someone who you trust most. Talk to a psychologist or a psychiatrist about it. 

Or feel free to talk to me on this blog, on my facebook, wherever you want..I will try my hardest to help you.

My facebook page is here:
Comment below anonymously if you'd like.

And by the way, Frank isn't actually my friend's name. It's just a name I made up to protect his, and his family's, confidentiality.


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