The Sound of Her Wings

Funny how death comes to people who embrace life, and how death plays coy to people who are sick and tired of the chance at life.

Rotating at the obstetrics and gynecology department was memorable for me, because the patients I have encountered there are extra friendly, and they seem to be more comfortable with sharing their lives to others. They would talk about their dreams and ambitions, their success and failures. In the ward for trophoblastic diseases, wherein the patients have been hospitalized for months, every patient knows my name, because one of the patients there kept referring to me as her future husband, and talks about me incessantly, according to the other patients. They seem to look forward to each time I was on solo duty at the ward. All the teasing and catcalls seem to brighten up the otherwise gloomy place. I didn't mind though, I was glad to bring a little amusement into their lives, even if i wasn't actively participating in such amusement. One of the patients there was placed in the isolation room. She had choriocarcinoma with vaginal metastasis, and was bleeding profusely. She was immunocompromised, but the main reason why she was placed in isolation was because of the foul odor resulting from her disease, which was unpleasant to the other patients. The smell of decaying fish filled the small room. I didn't mind the stench though, I got used to far worse odors. Decaying flesh on a live human smells worse. Her husband and I were her sole connection to the outside world. She was just admitted the previous day. She had been doctor shopping for about a year, and she was only given the correct diagnosis when she sought consult at PGH. She was admitted and scheduled for operation, but it seemed that it was too late. If she was admitted earlier in the course of her disease, the prognosis wouldn't have been as bad. I guess she has grown weary of speaking to her husband who was always at her bedside, so she kept on talking to me every time I would check on her. She really seemed interested in my life, with questions about what I do, my life in med school, my family, my friends, my life outside the hospital... and she talked about her life, her occupation, her family, her children, and how her illness has altered their family's life. She was perenially on blood transfusion,so I have to check for reactions, and she was always bleeding, from minimal to profuse, that i have to insert a thick roll of gauze into her vagina every now and then because it was always soaked. The process was painful, I can see it in her face. But she trusted me, she knew I was doing what was needed to be done. She was confident that her operation the next day would be successful, that she would be well afterwards, good as new. She would continue her life, and there are a lot of things that she still wanted to do. I didn't have the heart to tell her about the prognosis. For the whole night, I was practically at her bedside, leaving only to monitor other patients in the ward, or if another patient needed something. After two days, I was stationed at the post anesthesia care unit, and I didn't even recognize her until I saw her name on the chart. She was a very thin woman when I was with her two nights before, and the woman bearing her same name who was comatose on the bed before me looked grossly overweight at first glance. She was bloated beyond recognition because of edema. I knew she would pass away soon... her pupils were slowly reactive, and her Glasgow Coma Scale score was consistently 3, which was the lowest GCS one can have. She died the next day. apparently, her body wasn't strong enough to withstand the stress from the operation. She had so much to live, and she desperately wants to cling on to the life that was taken from her.

I remember the patient I posted on a previous entry last May. She too transferred from doctor to doctor, and she was only diagnosed correctly in PGH. What was sad was she was seen at the OPD, and they kept sending her home instead of admitting her. She was admitted when it was too late. Her abdomen was grossly enlarged due to massive ascites, and she was very cachexic. i think she was admitted because she could hardly breath. I first encountered her in the admitting section, and she was begging me to cure her--- to save her life. She was subsequently assigned to me at the ward, and I had to assist in her operation. At that late stage, she would either die any moment from the illness or from the stress of operation, so it wouldn't hurt to try to operate on her. Before she was given anesthesia, she kept holding my hand, still begging me to cure her, telling me she has so much to live for, she had many children still depending on her. She told me that she would've stayed home if she could, but her body can no longer stand the pain. She trusted our capabilities and she believed we can save her. She kept saying those words and she seemed to be delirious already. I just stood by her side. Everytime I look into her eyes, her eyes showing desperation, as if begging for mercy, i try to fight back tears. I had so much pity for this woman. Death was very near for her. How can death come to such a person, who wants to live so much that she seemed to be begging for her life, as if her life was in our hands? A such a late stage, her life was in God's hands already. I kept thinking how those doctors assigned at the out patient department kept on sending her home, as they saw her disease progress. Why did they wait until the last minute? I kept thinking how incompetent or uncaring they were, and I was brewing with anger. 14 liters of ascites was drained, and the metastasis from her ovarian cancer was extensive. Her whole peritoneum was littered with metastasis, and so were her liver, spleen, pancreas, bladder, and intestines. There was no way she was going to live. I though she would make it, at least for a few more days because she was conversant the next day when I saw her in the post anesthesia care unit. I was wrong--- she passed away the next day.

Each day I saw a lot of other souls in the hospital like these patients, in all the other wards--- begging for dear life, yet death so stubbornly, still took it away from them.

In my life beyond the walls of the hospital, I have witnessed the work of death when a close friend of mine died 5 years ago. How I miss her. She was such good company, incredibly perky and always smiling, full of life and vigor, that she never failed to brighten up my day even when I was feeling so down. Even with so much problems, she never hated her life, saying there was so much in life that she should be happy for. Such a positive outlook was contagious. Even when she became pregnant out of wedlock, she took it in stride. Even when her family practically disowned her, she still looked at the bright side. Even with her problems with her good for nothing boyfriend, she just though of it as small bumps in the road called life. Then unexpectedly, one day, I heard she died in a car accident, not long after she gave birth. I still regret how I never came to her funeral, with the excuse that the place was too far and I had no means of transportation, that I might get lost, that I found no one to accompany me because she had a different set of friends --- God, I was such a baby back then. Giving such pathetic excuses still haunts me to this day. I didn't cry for her then, maybe because of shock and disbelief. Now i'm wondering why i'm fighting back belated tears as I remember her now. The fact that I never saw her in a casket seems comforting... it creates this illusion that my good friend is still alive somewhere, that I can still see her in the future.

On the other hand, there are people who view life as nothing, who think there's nothing to live for. When I rotated in the psychiatric department, I encountered a lot of patients who have had several suicide attempts. It's funny how death does not give her gift to those who seek it. When talking to them, they talk of hopelessness, loneliness, a life not worth living. They can't see the good things in life, they fail to see the positive things, or they just blatantly ignore the beauty of life. It can be puzzling to others how such people can exist... how such people like me can exist.

Not that I've ever actually attempted suicide, but I have been filled with suicidal thoughts a few years back. I had such trivial reasons. I wanted to die after a big fight with my family, or with my past girlfriend. I wanted to die after getting a low grade in an exam. And the most pathetic reason of all, i wanted to die just because I was late for class. Other reasons seemed to have a semblance of validity--- when I had problems that seem insurmountable, when I've done something really wrong, and my conscience kept on bothering me. I didn't talk about my problems with my friends, because i'm the type of person who chooses to keep his problems to himself. Others may think of my problems as trivial, and they would probably think of me as a lunatic when I talk about suicidal ideations. I don't think anyone knew, for I always put on a mask of happiness or indifference. I rarely showed a face of sadness and despair. I kept on thinking of ways to take my life. I thought of jumping from the roof of a building. I even thought of jumping from the roof of my house which was four stories high. The only thing that stopped me was the realization that i would probably still live, albeit with multiple fractures. I though of drowning myself in the bathroom, locking the door so it will be too late when they've found out what i have done. I though of hanging myself, but I can't find the right spot... our wooden ceiling would probably collapse, foiling my plan. I thought of using my grandfather's gun and shoot myself in the head, right through the roof of my mouth, or at the side of my temple... or use one huge, sharp kitchen knife and stab myself in the heart, because the more gory and the more bloody, the better. it would be more dramatic, it would create a lasting impact. But I eventually chickened out because I was afraid of the pain. I thought of driving my car at top speed and crashing it into a wall, but i didn't want such an expensive way of dying. Maybe I could wait at the sidewalk beside the free way, and just when a speeding bus is approaching, i would throw myself in front of it. What could be more dramatic than appearing on the news the next day? Such thoughts clouded my mind for years, and thankfully I have never made actual attempts to make such thoughts a reality. There were times when I would lock myself in a room, a nervous wreck, contemplating if I should go on with my plan, thinking about it for hours, even all night... I just lie on my bed silently contemplating. I thought there was no reason for living. Just pulling the plug was so tempting. When I was clouded with problems, it was tempting to take the easy way out. I kept hearing the sound of death's wings as she approaches, which seemed to seduce me into accepting her gift, the sound of her wings has a calming and soothing effect, promising that everything will be all right afterwards, that every pain would go away. Sometimes when I'm really ill, i would wish that she would approach me, to worsen the disease, to take my breath, and eventually take my miserable life with her. But in the end, I wasn't brave enough to accept her gift. I would drown myself in alcohol to numb the pain instead. Those poems about death that I've written somewhat served as an outlet. Thoughts of the afterlife also scare me. What if the myth of heaven and hell are true? With the way I've run my life, I would most probably suffer eternal damnation--- I'd rather delay the process by living in my own hell on earth in the meantime. If only I was sure that after death comes nothing, that everything would just go away, i would have probably pulled the plug years ago.

Maybe because i'm older now, or various added experiences have altered my perception of life... I no longer dwell on such suicidal thoughts. I've learned to see the beauty of life. There's so much to be happy about, every problem will eventually come to pass. One just needs to change his or her outlook in life, to focus on the good things and not on the bad things. i have so much to live for and be thankful for. God has given me so much, that I am better off than most. Even though there are a lot of detractors and rumor mongers floating around, I have great friends who are always there for me. I've realized that despite their many faults, I have a great family who loves me and will support me all the way. I am given everything that is needed. i know that i would cause deep sorrow to a number of people if I took my life away. It would be easier if I was really alone, maybe that's why suicide is easy for others --- If I was alone, taking my life would only affect myself, and no other people. I do not want to inflict pain to others, only to myself. Because there are times when I still hear the sound of her wings, teasing me, tempting me with her gift. i just wish my desire for her gift won't overcome the beauty that I now see in life, for despair can cloud one's vision. The sound of death's wings are ignored my others, despised by many... but the soothing sound that it makes can be hypnotizing at times, making one fall into a sweet trance. The sound can be magnetizing at certain times, at the right moment, at the right time --- at least for someone who tends to dwell in misery...

like me.