Sunday, November 05, 2006

shakespeare in life

to be, or not to be.immortal words. the only bard i could quote, since literature was not offered as a subject in my school. no matter, because i managed to pick up some eg. goodnight, goodnight, parting is such sweet sorrow, & some i learned the hard way eg. hell hath no fury like a woman scorned.

mr C has AAA. nope, that's not his credit rating & he's neither a member of the automobile association nor alcoholic anonymous. he has an Abdominal Aortic Aneurysm - an abnormal bulge in the main artery in the abdomen from a weakness of the vessel wall. it has grown to a diameter of over 5cm & needed to be repaired before it leaks or worse, ruptures - then all hell will truly break lose!

earlier, he had seen the urologist for difficulty in passing urine - typical of a prostate problem for someone his age. it was during a routine abdominal ultrasound examination that it was fortuitously discovered he also had AAA. the vascular surgeon was called in & as this was the more urgent problem, mr C agreed to have the aneurysm repaired 1st. as part of a pre-operative assessment for major surgery, he underwent a gamut of tests. the chest xray revealed that he has a suspicious-looking 3 cm nodule in his lung. unfortunately, the subsequent CT scan showed that this nodule, very likely cancerous, is too deep-seated to be removed without excising the whole lung as well.

to be, or not to be.

it looked like it was not going to be for mr C. he thought he only had a urinary disorder - the prostate surgery could be done in an hour & he'd be out of hospital in 2 days. then we found he also has AAA - the aortic repair could be done in 4 hours, he'd be in ICU for 2 days
& then discharged from hospital within a week. but this lung tumour is a different ballgame & adds a sinister dimension to the scenario. should he have the AAA repair & then to discover that he has incurable lung cancer? or maybe, proceed with lung surgery & then have the aneurysm rupture on him? shakespeare aptly described this scene, also in hamlet :

when sorrows come,
they come not single spies,
but in battalions.the logical way out of mr C's predicament is 1st, to biopsy the lung nodule, determine it's nature & assess if it's amenable to chemothearapy or radiotherapy. then decide the sequence of treatment option for the best survival. not an easy resolution. mr C has but a short time to confer with his family & we await his decision.

i face instances like this all the time, & it only serves to remind me of my own mortality. in my pursuit of dreams & ambitions, i often take for granted the many little things in life whose worth far exceed any worldly rewards. what price do we put on the power of sight, the ability to laugh & the unfailing love of our family? when do we decide that we should be contented with gifts our ungrateful selves have been bestowed upon but don't deserve? shakespeare may not have the answer but the wise men of yore did shed a clue :

give me neither poverty nor riches,
but give me only my daily bread.
otherwise, i may have too much & disown you
& say,"who is the Lord?"
or i may become poor & steal
& so dishonour the name of my God.

prov 30:8,9

19 comments:

LX said...

Life is fragile.. what can I say..

doc said...

lynnx,

yes, indeed it is. all the more reason we should treat it with respect.

Anonymous said...

Have you heard this song before?

Shadows are falling and I'm running out of breath
Keep me in your heart for awhile

If I leave you it doesn't mean I love you any less
Keep me in your heart for a while

When you get up in the morning and you see that crazy sun
Keep me in your heart for a while

- Warren Zevon in his song, Keep me in your heart.

There's always hope! When Zevon was diagnosed with lung cancer, he was told that he had only a few more months to live. Asked what he intended to do, he said he intended to enjoy every sandwich. He spent his last days visiting his two children and his music.

When we are confronted with our own mortality, what would we be forcusing on?

I like your closing on "relationship"!

Moments may be cloudly, but we know who holds tomorrow!

Captain Kangaroo said...

Hmmm...
"Alas prostate, i knew him too well aorta" -- :)

doc said...

yan,

thks again for your comment.

no, i have not heard of warren zevon but i'll definitely going to google him.

yes, everyday that we are alive is a bonus. i know of many who would swap places with me.

doc said...

frapps,

is that bard as well? or, did you just cook it up??

Las montaƱas said...

mortality...

Live one day at a time. For we do not know what the next day will hold for us.

But that should not stop us from reaching out and living life as it has been provided to us.

just me said...

I AM impressed with your shakespeare quotations and the connection with real life..
And then the link to the WORD of GOD...
Good reminder that life is like a "candle in the wind"

doc said...

las montanas,

thks for your comment.

living one day at a time is easier said than done, but yes, it's a good principle to live by.

i find life most fulfilling when i can do some good for someone else.

doc said...

just me,

thks for your comments. i can't claim to be a bard buff bcos all those quotes are freely available at his website.

yes, life IS fragile, isn't it?

Unknown said...

I'd say brochoscope and get a diagnosis on the lung lesion. Angiogram for CAD. I agree with treating the relentless pathology (lung ca) first and deal with damocles' sword later.

doc said...

bernard,

thks for your comment.

yes, that's the plan we mapped out but i think the poor chap is overwhelmed. he came in with poor stream urine & we've opened a pandora's box. the cost factor plays a major role, too, which may explain why he hasn't come back.

not all my postings have happy endings. sigh!

Unknown said...

oh.. i guess that happens. i've had my share of it too.

Anonymous said...

...that is the question,
whether 'tis nobler in the mind to suffer the slings and arrows of outrageous fortune,
or by taking arms against a sea of troubles,
and by opposing end them...
to sleep, to die, and to say
we end the heartache,
and the thousand natural shocks that flesh is heir to,
to die, to sleep,
to sleep and perchance...to dream,
but ay there's the rub.


Sorry, just couldn't resist - I was 'doing' these lines in my head, and I still can't recall this scene very well!

Got your link from Alex's blog - nice to see many doctors blogging! :)

doc said...

hi alwyn,

thks for your comment. it's obvious you are well-grounded in bard.

yeah, medics need an outlet to vent steam, too!

nyonyapenang said...

i'm as guilty of taking alot of things for granted. am learning and reminding myself again and again to slow down, take stock and be thankful for GOd's blessings.
thanks for popping by my 'kampung blog'.
have a great day. ;)

doc said...

nyonya,

thks for your comment.

we all are guilty at one time or other taking things for granted. sometimes things happen to gently remind us of our blessings - sometimes, we learn it the hard way.

Anonymous said...

when sorrows come,
they come not single spies,
but in battalions.

i like this prose from yr post

doc said...

bengbeng,

thanks for your kind comment but it is shakespeare who deserves your compliment. this prose can be found in hamlet, act IV, scene 5.