The Book Of Life

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In the book of life every page has two sides: we human beings fill the upper side with our plans, hopes and wishes, but providence writes on the other side, and what it ordains is seldom our goal. — Nisami

Being on call is one of the most difficult aspects of being a physician.  When most are in their bed sleeping, I often find myself jolted from the fog of sleepiness and fatigue.  On one such call night, I was paged about a young man who just turned twenty.  He was brought in by his family because he had overdosed on the deathly combination of sleeping pills and alcohol.  He survived and I went to talk to him after he was stable.  Surly was the word that came to my mind to describe his demeanor. 

He insisted to me that he had not wanted to kill himself.  He had just taken the sleeping pills to sleep.  And why the alcohol? 

“I drink every night,” he said rather matter of fact, “I usually drink till I can?t drink anymore. I drink till I pass out.”  His blood alcohol level confirmed this.  

“Why do you drink so much.  What do you get out of it?” I asked.  He looked away from me, and stared blankly at the heart rhythm blips on the monitor.  I continued to ask him questions, none of which detracted from his staring.  Silence now seemed to be his only response.  I decided to talk to his mother who was waiting in the triage room.  As I was pulling the curtain away, my back towards him, I heard him say, “I don?t understand why everybody is making such a fuss.  I did not want to kill myself.  Even if I did, it?s my life and if I want to end it, it?s my choice to make.”

There was an honesty in his statement along with a hint of helplessness and hopelessness.

“Why would you choose to end your life? Are you not happy?” I asked quietly.

He did not answer.  He looked away from me, shut his eyes and told me that he wanted to sleep. I stood there for a few seconds watching him pretend to sleep and then decided to let him be.

As I talked to his distraught mother, a picture was building in my head about this young man.  He had just graduated high-school two years ago.  He was an average student in high-school, and seemed well-adjusted.  But now he was struggling in college.  His grades were poor and he was failing courses. 

“He has trouble finding his place in the world”, his mother said, wiping tears from her eyes.  He doesn?t know what he wants to do with his life.”  “He is a good kid”, she told me.  Lately he had seemed depressed.  He was mostly irritable and did not want to talk to her.  He would only come home to sleep and yes, on most nights he came home drunk.  He didn?t get along with his father.  There were lots of conflicts between both of them, because of course “his father thought that he was throwing his life away”.  She did not know what to do.  Discipline from his father was not working but even her understanding, loving, motherly ways were not working.  And now this.  She had found him on his bedroom floor face down.  She had thought he was dead.

The ER doc came to find me during my interview with her.  The young man was up and ready to leave.  He was pulling out his monitoring strips and was demanding to leave.  We discussed our options. We could keep him in hospital forcibly but what would be the point of that.  How useful is it to help people who do not want to help themselves?

I went to talk to him. 

“No! I was not trying to kill myself.  I was just drinking and took some sleeping pills to sleep!”

“No! I am not depressed,” he snarled, “I just wish everybody would leave me alone.”

When asked about his mother and her visible sadness over his drinking and this latest incident, he looked like he regretted his actions for a second but then apathy ruled his face again, “Look, its my life, I can do what I want.  I want to leave.”

I gave him a follow-up appointment at the crisis clinic for the next day.  He did not show to the appointment.  His mother apologized for him on the phone.  Nothing had changed in his behaviour.  His attitude remained in my mind for days to come.

How does a young person become disillusioned with life so much so that the only way to live a life is to “pass out drunk” or end life itself. 

From a young age, we are groomed to be the “best that we can be”, and that all is possible “if you only put your mind to it”. We learn that we live in a world of endless possibilities, in an age where we can make our dreams come true.  But in learning how to live our life, what do we learn about life itself?  Do we learn that there are periods where life can be full of misery, suffering and loneliness? Do we learn that no matter how much some might try they can never have what they want most because circumstances or luck or fate are allied against them? Do we learn that at its best moments, life is happiness and its worst moments, life is pain?  Do we learn that during these best and worst moments, we live for those who love us and we live to love? 

What happens when our expectations from life confront the realities of life?  How do we cope with the inevitable disappointment and unhappiness?  Living a life, with all its best and worst moments, is difficult but expands and elevates our human spirit.  Merely existing till life has been exhausted is understandable but is a great tragedy and a supreme loss.

Author: Tanya Pinto- Canada

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