I suddenly lost passion to write. I was too depressed, I suppose. Maybe, just too busy! Actually maybe I know why, but just haven’t come to terms about it!

It started end of last week actually when I had an elderly lady presenting with intestinal obstruction.

Upon doing a gentle colonoscopy, she was found to have an obstructive lesion in the right colon. The anaesthetist, though being a good friend was extremely reluctant to call the case. After much of argumentative discussion, she gave in and yet even throughout the surgery she insisted that this is not an emergency. This was our third right sided colonic cancer in an elderly within a short period of 2 weeks.

A few days later, I saw this nice gentleman, in his 40′s, looking wasted and breathless! His misery started 9 months ago, when he was labelled as to have tuberculosis(TB).

Despite all investigations being negative for TB, he continued to be treated as one. He was started on the medications and never showed any improvements. He then started to complain of fresh blood with his stools he passes out. It fell on deaf ears and they assumed it was TB. Months pass by, his queries were brushed off until a month ago, someone decided to listen. He was then referred to us for a colonoscopy and a CT scan.

He had cancer of his upper rectum and it has disseminated throughout his body. He was too breathless to even walk a few steps. He was unfit for any procedure even for any chemotheraphy. Today, he took a down turn and was appearing lethargic. He was developing muscle fatigue. He was getting weak. I called his wife and children. I spoke to them and adviced them. They managed to take him home.

Just a few beds away from his is a Chinese gentleman, who recognised me the instant I appeared in front of him. I was his doctor when he was operated by my bosses back in University Hospital,UMMC. He had recurrence of his stomach cancer and was also breathless. His chest wall was infiltrated with cancer cells that made his chest expansion restricted. He too was getting tired of breathing but wanted to go home the next day. However, towards the evening, his saturation dipped and he was dry and extremely tired. He wanted to go home. Again, I assisted him to feel as comfortable as he could be and he afforded me a smile and a handshake. He wanted to die at home. We rushed the private ambulance and got them to rent an oxygen tank for home use. Just as they arrived, he slumped unconscious on his chair. He was gasping. As I felt for his pulse, I saw him blow his last breath.

Then, in between all this, there was another emotional case where a young Indian girl, 21 years old, who was diagnosed to have fibroadenoma after an ultrasound and biopsy, underwent an excision of the mass. The final pathology report revealed a focus of cancer. The mother was devastated as, this young daughter of hers was just about to start work and was still unmarried. She said, ” Even if I accept this diagnosis, and even if I accept the treatment protocol, this is actually just the beginning of all her problems.” 21 years old with breast cancer and requiring a mastectomy and an axillary clearance. Her mother is correct, this is just the begining for her. She would definitely require a support group.