"You've been sentenced to death by disease."

Who died and made you the judge?

One might rightfully ask me.

Here's a story that explains the week that was. And what a week this was!

I could not remember where the last week ended and this one began. While it was a traditional wiped out weekend for the rest of the world, I was, with my amazing team of surgeons, what I'd like to call, beyond awake. We transcended into spiritual consciousness and back to wiping shit by the end of this week.

In the background of a plethora of patients who showed up with some cancer or the other, and among various organs removed, one incident stuck in my head. I wouldn't remember the daily traffic of patients by their names but these two sure made a mark. 

It was Tuesday. A Mrs. L with ovarian cancer was scheduled  for the Mother-of-all-surgeries, we call Cytoreduction. Mrs. L is 43 years old. She completed 3 cycles of chemotherapy like the rest of the advanced ovarian cancer patients, and now was up for her chance at a prolonged survival. Well that's what we thought. After all she has school-going children and a disabled husband. She entered the OR. She was prepped and positioned as usual. We were all positive. We put in a laparoscope as a tradition to assess the operability but in her case there was something ominous about her chest CT that made us first put in a camera scope in the left side of her chest. What did we see? Disease like creeping fungus everywhere. 

There. She was sentenced. Never to return to the OR.

Was it sad and depressing then? I honestly do not remember feeling anything. I just knew that the waiting list for surgery is too long and maybe this OR time could be used for someone else. So we did what anyone does at a high volume centre like ours. We wheeled in another Mrs.P with ovarian cancer who also underwent 3 chemotherapy sessions and was now looking for prolonged survival. Mrs. P is 75 years old. All her children are settled and have children of their own and they all showed up in such short notice to see her off to such a major surgery.

I followed tradition and put in a laparoscope in her abdomen. Her cancer responded beautifully to the chemotherapy and had minimal residual cancer. Easy to operate. Faster to operate. Faster to recover and go back frolicking to her family.

Mrs. P was free to go.

Who makes these judgements? Who wrote the rule book? Who decides that a 43 year old young mother loses her battle and a 75 year old lady wins? What is that factor? 

They were both identical as far as the disease aggressiveness documented by the biopsy was concerned. Then why this difference?

I guess we will never know. We will never be in a position to accept the laws of nature, no matter how obscure. We will never be able to appreciate the presence of a supreme being no matter what the purpose. We can never accept the suffering of a child of 16 years dying of florid ovarian cancer and accept the ultimate truth of the Book. Is it just me who is severely conflicted or does this make sense?