Date Archives December 2023

A PAGE FROM A DOCTORS’ DIARY

Blog Weight Beyond Weight
Unseen Struggles: The Weight Beyond Weight

Unseen Struggles: The Weight Beyond Weight

©Dr. Aparna Govil Bhasker

This is the story of Shruti and Raj (names changed). A touching journey of profound emotions woven through an array of love, loss and unyielding hope amidst a backdrop of deepset societal prejudices and biases.

As a young couple, their quest to start a family was laden with challenges. The initial elation of finally conceiving a pair of twins through IVF, was swiftly eclipsed by the cruel hand of fate. Losing one of the twins in the early months of conception left them reeling with grief. Despite the heartache, they clung onto the flickering hope for their remaining baby, channelling every bit of love and determination towards nurturing that fragile life.

In a heart-wrenching twist of destiny, just days before the expected delivery, their journey took yet another unexpected turn. They were shattered when the second baby’s heartbeat stopped in the womb and they faced loss once again. Their world was engulfed by the painful reality of losing both babies, leaving them immersed in profound grief.

The year was 2020 and amidst their ordeal, the world was overtaken by the chaos of the Covid-19 pandemic. Shruti, already battling with the weight of grief, found herself grappling with a severe bout of Covid. Once again, she was admitted for weeks in the hospital. Treatment with steroids saved her life but the side effects brought unwanted #weightgain. The pandemic restrictions further isolated her, eliminating avenues for physical activity and exacerbating her struggles emotionally as well as physically. A few months passed by.

As if her already overwhelming trials weren’t enough, one year later, she started experiencing an excruciating pain in the left hip joint. She was diagnosed with avascular necrosis of the hip, a consequence of the steroids that she required during treatment for Covid. At a young age of 28, she faced the daunting reality of needing a hip replacement, an unforeseen challenge that added to her physical limitations and struggles. Each step became a battle and every movement a painful reminder of her body’s limitations. Coupled with her restricted mobility, it became an additional factor contributing to her weight gain.

Shruti’s struggles with her health issues weren’t merely confined to their physical toll. The most profound blow stemmed from the absence of understanding and empathy from those around her. Society’s unforgiving lens fixated solely on her outward appearance, remaining oblivious to the turmoil raging beneath the surface. Instead of offering empathy or a listening ear, they chose the path of blame—an unjust attribution of her weight gain to her actions, without acknowledging the intricate complexities she struggled with.

The understanding of #obesity needs to extend far beyond superficial judgements. Beyond the visual appearance lie many emotional and physical struggles that shape an individual’s journey with weight gain. While it’s easy to cast aspersions, true understanding requires a deeper connection, an effort to empathize with the multifaceted challenges faced by individuals. Sadly, in today’s world, obesity stands amongst the most stigmatized conditions, frequently greeted with a glaring lack of empathy. Instead of kindness, those affected often confront sneers, harsh judgments, and biased attitudes, exacerbating their already uphill battles.

Amid this tumult, Raj remains an unwavering source of support for Shruti. His love and belief in her never falter as he tirelessly advocates for her well-being and offers unwavering support.

Shruti’s yearning for a family and a life liberated from judgement remains resolute. Her dream transcends mere physical weight loss. It encompasses liberation from the confines of societal judgement and misconceptions. What she longs for is a world where her narrative finds resonance, where her trials are met not with disdain but with empathy, understanding, and heartfelt compassion.

In this world, as we all traverse our individual tests and trials the weight of these burdens tends to feel less heavy when we encounter understanding, empathy, and genuine compassion from others. Individuals dealing with obesity often face the unfortunate reality of not being truly heard or seen beyond their outward appearance. It’s important for society to listen to and truly see individuals dealing with obesity. Acknowledging their experiences and understanding the multifaceted nature of their struggles can pave the way for a more supportive and compassionate approach towards addressing this condition.

OPERATING ON THE EDGE- THE UNSEEN JOURNEY OF SURGEONS

JOURNEY OF SURGEONS
OPERATING ON THE EDGE- THE UNSEEN JOURNEY OF SURGEONS

©Dr. Aparna Govil Bhasker

It was the last case on the list on that day. A very routine laparoscopic fundoplication that took an unexpected turn. In a fateful moment, a short gastric vessel ruptured, with torrential bleeding across the surgical field. Suddenly, all I could see on the screen was a bright red splash of colour obscuring everything else. A surge of panic coursed through me, and I could distinctly feel the rapid, intense pounding of my heart. My mind raced faster than my heartbeat – what if the bleeding couldn’t be stemmed, if the procedure needed conversion to an open surgery, if a splenectomy was necessary or worse, if things went south? And even though potential complications are always explained prior to surgery and consents are duly signed, in that intense moment, I felt intensely weighed down by the prospects of having to justify something like this to the patient and the family later.

Within a heartbeat, I regained composure, drawing strength from years of rigorous training and experience, and perhaps a touch of divine intervention. It felt like a battle I couldn’t afford to lose—a target that could not be missed. Complete focus became paramount, as every passing moment would reduce my chances of winning. In that fleeting instant, with unwavering determination, I seized control over the bleeding, witnessing the haemorrhage stop as abruptly as it had started. The field was clear once again. I heaved a big sigh of relief, went on to complete the surgery with my team and later everything was fine. The patient, unaware of the precarious precipice they skirted, recovered and was discharged, the episode fading into a memory of a successful surgery.

HOWEVER, BEHIND THE SCENES, WAS EVERYTHING REALLY FINE? 

A surgeon’s silent struggle with the aftermath of such high-stress surgical moments is not much talked about. There exists an unspoken burden, an emotional fallout, that surgeons carry post-operation, which is unacknowledged by most.

As surgeons, we undergo rigorous training, assuming that alongside our surgical skills, we are equipped mentally to navigate these critical junctures. Yet, reality often diverges from this assumption. 

The weight of a patient’s life rests squarely on our shoulders, and when confronted with such intense scenarios, the physical, mental and emotional turmoil can be overwhelming.

Despite effectively managing the crisis, the haunting realization of what might have transpired, lingered for days in my mind. Although the entire episode during the surgery had lasted for just about 15 seconds or so, for many days, I experienced physical manifestations of stress – low energy levels, mild anxiety, throbbing headaches, neck spasms, and debilitating fatigue. It is not uncommon for doctors/surgeons to experience symptoms of acute gastritis, insomnia, spondylitis, diarrhoea and sometimes even menstrual irregularities as an aftermath of stress. 

As surgeons, we routinely navigate through high-intensity stress scenarios. The serene and composed atmosphere of the surgical field can transform into a battleground at any given moment. While our profession doesn’t grant medals for bravery, failure is simply not an acceptable option. This consistent and prolonged exposure to high-pressure scenarios spanning through a long surgical career, fosters chronic stress, which can further manifest physically as hypertension, cardiovascular disease, diabetes, and other health issues. Additionally, it can exact an emotional and mental toll, potentially leading to various forms of depression. Higher suicide rates amongst doctors have remained a concern for quite some time now.

Reflecting on my own experience, this particular incident wasn’t the first of its kind in my clinical practice. Like many surgeons, such moments have become a familiar part of my daily life, too. We often internalize these experiences, deliberately understating their significance, avoiding extensive discussions or acknowledgment. What transpires within the operation theatre typically stays confined within those sterile walls. Over time, it’s almost as if we build walls around ourselves, inhibiting our willingness to share and communicate. 

Many of us in the surgical field, myself included, pride ourselves on our ability to swiftly forge ahead. The rationale being that immersing ourselves quickly back into work, aids in overcoming these thoughts and emotions, contributing to our resilience. However, this culture of resilience prevalent within the medical community, though admirable, often comes at a price. Surgeons are left to grapple with their emotions in solitary introspection, navigating uncharted emotional territories without the necessary guidance or support systems in place.

THE NEED FOR SOLUTIONS IS URGENT.

Firstly, acknowledging the impact of professional stress and the emotional burden that surgeons carry is essential. It involves recognizing that these experiences can have significant effects on mental and physical health, as well as on overall well-being.

Acceptance comes in understanding that it’s okay to take a step back and prioritize self-care. Many healthcare professionals often push themselves relentlessly, believing that taking a break or seeking support is a sign of weakness or may negatively impact their ability to care for their patients. However, this mindset needs to shift.

Being kinder to oneself means recognizing personal limits and the importance of self-compassion. Allowing time for rest, recuperation, and seeking support isn’t a sign of inadequacy but rather a necessary step towards maintaining mental health. A rested and emotionally balanced healthcare provider can potentially offer better care to their patients.

Taking breaks, seeking support networks, and practicing self-care can potentially enhance a surgeon’s mental clarity, emotional resilience, and overall effectiveness in their profession. It’s vital to understand that caring for oneself doesn’t compromise the quality of care provided to patients; in fact, it can enhance it.

A systemic shift in the medical culture is imperative. Encouraging a healthy work-life balance, emphasizing the importance of self-care, and destigmatizing seeking help for mental health challenges should be prioritized.

As surgeons, we are entrusted with the profound responsibility of preserving lives, a duty we hold with utmost reverence. However, it’s equally vital to recognize that safeguarding our mental and physical well-being is pivotal for providing optimal patient care. It’s time to acknowledge the unspoken toll on surgeons and pave the way for a healthier, more supportive environment within the medical community.