Monday, November 28, 2011

Silence and safety

It's a cold, quiet night, and my current rotation has me on clinic, so I'm not anxiously awaiting the pager. So naturally I'm reflecting. The last nine years have changed me, as I related here, and I've achieved at least one dream in being a cardiology fellow. But tonight, I came across a poem by Sassoon that brought me back to my third year as a medical student, watching a patient die for the first time. The poem, which you should read (assuming I still have any readers, and you care) is called The Death Bed. The part that got to me is this:

Light many lamps and gather round his bed.
Lend him your eyes, warm blood, and will to live.
Speak to him; rouse him; you may save him yet.
He’s young; he hated War; how should he die
When cruel old campaigners win safe through?

But death replied: ‘I choose him.’ So he went,
And there was silence in the summer night;
Silence and safety; and the veils of sleep.
Then, far away, the thudding of the guns.

It is perhaps an open secret that I did several of my medical school rotations in military hospitals, and the perspective I have on war is perhaps more visceral than that of most who haven't been in one. I've never been shot at, but seven years ago, I watched someone who had go through the lines above. It seemed pointless. I probably tried to write the poignancy of the scene, which happened literally minutes after the news station (filming a special on the soldier and his pregnant wife, carrying a baby he would never see) turned off the cameras and walked away. But I am not the writer he deserved. Sasson was.

I wonder what he accomplished. What he saw as the great purpose of his nearly two and a half decades of life. I realize that, as a modestly terrified med student on surgery, I knew far, far more about his vital signs than whatever it was that made him truly vital, truly human. But I wanted to lend him my will to live, nonetheless. I still do.

My last few posts talked about moving away from the direct experience of patients and more into management. I now know that process is what friends warned me against when saying "don't let them change you" as I shuffled off to yet another school that summer in 2003. The change creeps up without the changed noticing how great it is. But sometimes the realization breaks through and a refreshing of humanity comes back.

So it is good tonight to sit in silence, far away, and weep for a soldier.