Bitter sweet symphony

We arrive in Peponi and as I am sitting at the bar, beer in hand looking out to sea, watching my children happily playing in the water with two of the team from Hereford, I feel myself physically relaxing. It is a strange sensation as although it has been a hard week (mainly through family illness), I was clearly somewhat blinded to how I was really feeling – I think you just go into autopilot and get on with it. However, in this stunning location, with the waves gently lapping on the sand, the wind blowing a gentle breeze – partly cooling, partly warming, a strange parody that could not be more perfect – I really do feel in paradise. The stresses of life just fading away, melting into insignificance. Moments like this really are to be savoured. They are so simple. They are what make us human. You can look and look for them, search for a lifetime, then all of a sudden they just find you.   

However, I also have a pang of regret in leaving Muheza today. Having done an emergency case this morning and tidied up a few loose ends, I was literally walking from the building. Striding into the full heat of the day, my name was called, “Dr Mark”, stopping me in my tracks. Emphatically, it was recounted to me that there was rumour of a patient who might be in bowel obstruction. They wanted me to review. A laparotomy might be required. I was torn. My professional self was in no doubt – turn around and walk straight back into the hospital. I was needed, and although I would probably be committing myself to another 4-6hrs in the hospital, it would probably be good for the patient and good experience for the team. However, I had other responsibilities, to my family (not least my wife who was in grave need of escaping for the weekend to recover) and the Hereford team, with whom we were going to Peponi. I was to drive us all in the Hospice car. If we didn’t go soon, we would not be able to leave this afternoon and would have to forego the evening’s accommodation we had booked. I was also tired. Physically, emotionally. I did not have much left to give today.

There is no right decision in these situations. Whatever you do is wrong. And this epitomises one of the greatest challenges in coming somewhere like this. You can always do more. The need is always great. And there is usually no-one else to do it. No-one to ‘hand over to’. I knew that in excusing myself, I was probably committing that patient to a transfer to another hospital (which would be the routine practice had I not been here), assuming the ‘rumours’ were accurate. And I knew that in walking away I would personally take a ‘hit’ on my professional conscience. I have always stood by the mantra of ‘doing the right thing’. Many a time it has caught up with me striding down a hospital corridor, making me turn around to go back and check something for myself (invariably all fine, but occasionally not). “It is probably ok”, is something I have never been comfortable with. Perhaps that is a good thing, perhaps not. But it is part of what makes me, me.

Today, I was committed. Deep down I knew what I had to do. However hard it was. I apologised and walked out of the hospital. And it was hard. So very hard. Another situation I would never choose to find myself in.

It was perhaps never really ‘my’ decision to make. Responsibilities come in many different guises. Regardless, I felt bad. Later, when we had arrived in paradise, I wanted to know. Perhaps I needed to know. I sent a message. I got a reply. The patient was indeed transferred. Hmmm. Fingers crossed they will be ok.

Can you ever do the right thing is these situations?