Archives of The Cheerful Oncologist, Volume 2

I could a tale unfold whose lightest word
Would harrow up thy soul, freeze thy young blood,

-William Shakespeare

The hour was after midnight. I walked into the night to my Ferrari-like roadster parked under the dim lamps in a joyless square of the hospital parking lot, plenty of time on my hands to reflect on what had just happened.

Time I had indeed. Energy and concentration, however, had gurgled down into my shoes, leaving me about as spirited as a Johnny Reb after Pickett’s charge. Any passing motorist would have noticed how my vehicle traveled down the highway with a distinct lack of exuberance; in fact, I wouldn’t have been surprised if I was pulled over for failure to drive with attitude. The road rushed up from the darkness into my headlights as I weaved past silent neighborhoods. Once home, using a unique combination of junk food and cable television I was able to unwind to the point where gentle slumber, with its special offer of sweet dreams (not available in stores), seemed the perfect bargain. I left the world behind as soon as my pompadour hit the pillow.

Unfortunately for me the world resents being left at the altar of consciousness. It likes to torment those who roam the earth, especially roamers in their right minds, unleashing its Pandora’s box of worries about life in the modern age. Even in dreamland it can hunt down the smiling snorer and change reels right in the middle of the show, right at the part where our hero is flying like Superman to the local lottery headquarters to pocket a check of stupifying size. This might explain why I experienced the following dream:

I was out in the desert when I came across a hiker lying under the vicious sun, obviously suffering from its ill effects. I carried him to a building that conveniently morphed into a hospital as I crossed the threshold. The E.R team instantly began to work on the victim, but as they went to put in an I.V. he suddenly sat bolt upright and said, “You can’t give me any intravenous fluids!”

“Because in my religion we don’t accept anything by vein. It is against our belief!” He lay back down again and began to hum the sextet from Lucia de Lammermoor.

Well, the rest of the fantasy is rather fuzzy, but I seem to recall the staff placing the patient in an icy bathtub and feeding him glass after glass of tomato juice. It was at that point that I awoke with a gasp, squinting into the tomb-like darkness at a familiar green dial. The ghostly numbers announced to the world (which, looking for more opportunities for mischief had gleefully returned post-haste from dreamland) that the time was twenty minutes to five. Silence held dominion over all. Not even one soloist from nature’s feathered glee club had left the nest for the morning concert. This of course allowed me to ruminate without distraction - and ruminate I did, ending any last chance for sleep.

The dream had forced me to confront the fact that I had been at the hospital seeing a patient in consultation who was close to exsanguinating after an operation. Blood was the key element that was missing from the patient, and a blood transfusion was exactly what the doctor should have ordered - except he didn’t. Instead he asked for me. Why, you ask?

The patient was a Jehovah’s witness, and accepting blood is considered a sin in this religion.

Thus my nightmare was simply a reflection of the panic I felt just hours ago as I stood over this patient, looking down at his blood-stained bandages. Luckily I wasn’t dreaming at the time and took advantage of this fact to perform a quick check on my senses. Finding them still in my possession I therefore searched for some morsel of information that would inspire my forthcoming recommendations and soon uncovered a clue. The patient had evidence of platelet dysfunction; why, I could not readily ascertain but it made no difference now. I quickly conjured up a dose of desmopressin and sent the order to the pharmacy tout suite.

It turns out that the bleeding did stop, and the patient stabilized, meaning that he no longer induced waves of sweat-soaked terror in his physicians. This is generally considered to be a good start to one’s day, if you know what I mean.

Irony is found all throughout the field of medicine. The wise physician knows when to stop and marvel at it and when to brush it aside like a bullfighter making his way to the ring. When a doctor is consulted to save a bleeding patient but not allowed to use blood as part of the cure, that is ironic. It is so ironic that if the treatment works one might even call it a feat of magic - and as we all know a magic trick that works perfectly one time may flop the next, spilling cards all over the table. Keep this in mind the next time you or your loved one is confronted with a disease grown desperate.