Last week I was writing about an amazing book I’d discovered called Final Exam:  A Surgeon’s Reflections on Mortality by Dr. Pauline Chen.   More specifically, I was wrestling with a passage in the book that tells of a baby named Max, born with such severe abdominal abnormalities that his (donated) liver and intestines were held in place by a stitched-on piece of plastic. 

The baby’s medical setbacks were agonizing, until eventually, despite deploying every medical advancement at their disposal, Max’s physicians and surgeons failed to arrest what felt inevitable—the little boy’s death.  Dr. Chen painted such a vivid picture of Max’s brief life and Herculean treatment that it was impossible not to feel equal measures relief and devastation when his suffering finally ended.   

I was using the passage to illustrate the ends to which doctor’s are driven in their overriding quest for a ‘cure’.  Because in order to approach old age and dying, or really any medical event or chronic condition, it is critical to understand the psychology of being a physician—what drives them and makes them tick.  Without that vital piece of information, our hope of successfully navigating the slippery slopes of medical intervention becomes dicey, at best.

In the case of Max, the physicians/surgeons quest for a cure began to feel like one of those slopes—moving ahead with one treatment led to doing another treatment led to doing this surgery led to doing that surgery led to doing more and more and more and never stopping.   It began to feel like torture—inhumane, single minded, irresponsible—as though Max’s humanity disappeared in favor of medical intervention.

I wrote how angry this made me, how indignant.  It’s a tiny baby boy, for god’s sake.  Are you really trying to convince me that what was done to his body on the altar of almighty medicine was justifiable?  Warranted?  Humane?  In my mind, I brokered no argument:  the doctor’s had been wrong—I was right—someone should have stopped the merry-go-round and let poor Max climb off.

Karma, if you believe in such a thing, is so humbling. 

At our local racetrack last weekend I had the chance to check-off an item on my bucket list—riding in a real-live race car on a real-live racetrack.  It had been on my list for as long as I can remember, and while I figured it was more likely to happen than say, a ride in an F-14 fighter jet (number three on my list), I was still giddy at the prospect.  When we pulled up at the track I could see the race car and it’s driver, and I could also see a tiny helmet in the passenger seat, sitting so low the top barely cleared the window. 

Oh that's cool, I thought, some little kid is getting a ride too.  The lucky bugger….

Talking with our host as the kid and his driver whizzed around the track, we were told the boy suffered from terminal cancer and probably wouldn’t live to see the summer end.  He had chosen this experience over a trip to Disneyland.  He was only four years old.  At first, I didn’t really know how to react to this information, except to tell our host that if it came down to a choice between the kid getting two rides or me getting one, then go ahead and give my ride to the kid. 

When his ride was over we both gazed rapturously into the race car's cooling, ticking engine. 

He asked me what I was doing.  I squatted down and said I'm doing the same thing you are, looking at the car’s engine.  He asked why—the quintessential four-year-old question—to which I had no good answer other than because it was awesome.  We chatted for another moment before he grew weary of my company and took off, oblivious to the inner conflict he’d ignited.  Because while he stood next to me, I couldn’t help thinking this kid does not look sick; he should definitely not be dying.  This kid is vibrant, happy, excited, and so cute I want to reach out and touch him.  He can’t possibly be dying.

I think fate put this small boy into my path to show me the error of my thinking, that I might know what's best for another person's child.

I imagined being his father or mother, imagined seeing my kid so incredibly alive, so present, and not letting that go without a serious, and I mean hardcore, battle.  And if I could feel that way about a little boy who was in my life for all of two minutes, how much more would that feeling dominate if the kid were my own?  How would I feel if I were that child’s treating physician, with nothing short of his life hanging in the balance?   How can any of us really know how we’ll react to the looming threat of death, whether our own or our loved ones? 

Ah, universe.  Once again you’ve made it obvious I’m much too quick to judge, too swift off the line when the situation is at a distance.  How easily I slip into armchair quarterbacking and how wrong I am to assume I know better—because I don’t—a lesson I thought I'd already learned. 

Guess the universe knew I needed a refresher. 

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