are we winning?

Ha. How funny it would have been to just keep just this one first entry in the journal about tomorrow being my first day and then to disappear. Maybe someday someone would have read it and wondered what happened.

But what actually happens is this: I work fourteen hours a day. That is just the thing with doctors – they are wealthy because they have no time to spend the money they earn and miserable because they have nobody to tell the stories they encounter. But oh my, what stories they are.

Just this week I had this patient, 29 years old, a weird kind of run-down attractive. He came to our A&E in the middle of the night complaining of brutal back pain and a very atypical hypaesthesia – his whole back and lower legs were numb. When I examined him he was pettish, tight-lipped and rather uncooperative, and his gaze was either avoided or uncomfortably intense. He was not making any effort when I tested his muscle strength, and his left arm drifted down without pronation in the pyramidal drift test. We did what all doctors here do, called him a crackpot and ran a few tests. The MRI came back clear, the motor and sensory evoked potentials were without any pathological findings and the spinal fluid was completely normal (“We didn’t expect anything else, now did we?” my consultant half joked, half admonished).

So I went into the patient’s room preparing myself to tell him about his test results, that there was nothing wrong with his nervous system (“good news is…”), but that, well, there was nothing we could do for him in our department. I sat down with him and gently explained how sometimes the body would do funny things when the soul was troubled, all the time awaiting an outburst of indignation, an abased protest how we did not take him seriously and that he certainly is neither imagining nor simulating his symptoms. Instead, when he suddenly looked up at me I saw something in him slacken. And then he told me. How he never spoke about it before, how his life was a mess, how he himself was a mess and that he did not know how to move on.

Four years ago he went to a music festival with a couple of friends. Just as they were about to leave a mass panic broke out. It was all over the news – I remembered the media coverage and the typical aftermath of finding a scapegoat and deciding on new safety plans. I vividly recalled the photographs of people fighting for their lives and later photographs of flowers and candles and cheap teddy bears and pieces of paper saying “WHY?” and “WE WILL NEVER FORGET”.

He was in the middle of that mass panic. “I’m there. In every single picture I’m there. I saved four people. One girl was at my feet, I was not able to help her up, I was not able to breathe, people were just trampled down, others suffocated, that girl on the ground bit my leg and I to this day do not know if she lived or died.”

I listened to his story of how he got home on foot, how the next days went by in a daze of sleep and news channels, how he started to gamble and broke off all his social contacts, then thanked him for his trust, touched his hand and left to make a few calls. I won’t ever find out what happened to him.

And that feels really strange.