Oh well, the topic of this thread easily gives away its content.

I once had a patient whom I was very close to. Extremely close to. Will call him Mr. S, he was a young boy who we managed for type I diabetes and extensive Fournier's gangrene.

S and I were close, in fact, ours was beyond the typical doctor-patient relationship. Even when I was off duty, S would ring me for one issue or the other and I would appear in the ward to sort him out. Was pretty close to his mother and siblings too.

During the course of S's admission, he was transfused a number of times. His condition also requires steady antibiotics therapy and the meds were expensive. Of course, financial constraints became an issue. One time, they couldn't provide blood as they had run out of donors and finances for transfusion. I donated a unit of blood to S.

As a doctor, I knew S's condition was fast depreciating. He had become septic, his vital signs were screaming for urgent attention. He had an extensive collection of abscess in his urogenital region, thighs, and abdomen. He had become cachectic.

Despite these, his family remained entirely positive and very supportive. His mum never gave up. His elder brother was running around for funds and materials for his treatment. His sisters were always beside him, they never left his sight.

I was later moved to another unit but this didn't affect my relationship with S. I still found time to visit him and talk. One time, he told me, "doc, when this is all over, you and I will hang out and catch some fun."

This statement shot a beam of shivers down my spine. I knew his chances were minimal. I only gave a smile and reassured him.

Sometimes, I discuss about God with S and he was pretty happy to hold such discussions with me.

One night, or early morning, I got a call. 2/3am. It was S's mum. He had stopped breathing.

I dashed to the ward. Saw his motionless body lie in absolute peace, his eyes closed like he was having a satisfying sleep. For some reason, the sight of S's body gave me an impression of a prison whose door had been destroyed by the inmate who had gone on to enjoy complete freedom.

S, my dear friend and brother, was no more. His soul couldn't be recalled by the ressuscitative efforts of the workers on duty.

S, my dear friend and brother, was gone, he was free at last from the pains of the flesh.

When the mother saw me, it seemed she suddenly found strength to fuel her cries. She screamed and hugged me. His sisters sat beside him, their shoulders fallen. Other patients sat on their beds watching and absorbing the episode.

I held the mother and consoled her. I spoke the little Igbo I could. The nurses were also there. We all consoled the family.

As I left to my room, I could feel an ache expand in my heart's core. I felt the arteries in my head pulsate. I was shattered. Broken. I felt like screaming on the top of my voice.

But I'm a medical doctor, and I should be a super man. I maintained my calm and returned to my apartment.

The doctor consoles, but who consoles the doctor?

I'm still in communication with S's family. I recall they invited me to his burial but I couldn't make it, work didn't let me.

I know I'm supposed to maintain my limits while providing care to patients. Professional limits, that is. But right from medschool, I knew this was going to be a problem. I personalize things a lot. If I pick up a task, I'm easily dedicated and immersed in it. I don't see my patients as patients. I see them as humans - fathers, mothers, sons, daughters. I know that life is a weird complex, and tables can turn in an instant. A good number of my patients have invited me to their houses or events (mostly thanksgiving ceremony in their churches after discharge)... though I've not been able to honour any.

Because I am quite close to them, if I lose any, it hits me real hard.

I know I'm not the only one going through this. There are many doctors like me. I know of a consultant cardiologist who broke down when he lost a patient. That day, he called me and we were on phone for over 10 minutes. This man has got over 30 years of work years up his sleeves. I know of colleagues that cry when they lose their patients. Some just shutdown.

Society should understand that doctors are humans. Our work exposes us to hundreds of traumatic experiences that we stand at risk of coming down with a major depressive disorder. One study found that the rate of depression among physicians is as high as 29%. Other studies project much higher figures.

Not many doctors would want to talk about this. Perhaps, this may be because they want to protect their images or something. Oh well....

Maybe I should ask my colleagues, all healthcare providers, not just doctors...how do you cope with devastating treatment outcomes?

Cc: Dominique, Sissy3, Seun