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My mother and I finished our conversation about her diabetes and cancer with me sounding reassuring and in control. I used the gentle and encouraging voice I use with the patients I see everyday in PGH, the voice I use to calm small children when they cry, the voice I use to give bad news to patients about their illness. Inside, however, I was unmade. I managed to hide it from her—this feeling of helplessness—because I felt that to give in to it, at least publicly with her, was to do her a disservice. I am her son, yes, and I’ve thrown my many childhood uncertainties at her as I was growing up only to be always met with reassurance and encouragement. To her and to the rest of my family, I am now also her doctor (medical student that I am), and as her doctor I’ve been told to give hope and to be there for the patient. Now my mom was throwing her uncertainties at me, and in her moments of doubt and fear she would throw much more: hopelessness, despair at times, even her pain, and as her son and as her doctor, I try to meet her with the same reassurance and encouragement I’ve been met with as a child. Today, perhaps because I was tired from duty, I managed to be reassuring, but my lie was known to me: I felt as scared and as terrible as her.

It was heavy, this fear, this constant walking circles around the idea of her disease. I could not wrap my mind around my mother’s cancer, so advanced, detected so late even with the best of precautions. Because of what I learned in school I urged her to go on check ups every year, have ultrasound readings done even without symptoms, precisely because ovarian cancer does not have symptoms until it has grown big—many times too big—for cure. Every year she went, and subjected herself to the uncomfortable procedure of having a foreign object enter her body. The transvaginal ultrasound would paint a better picture of her abdomen, and that was what she would do, mostly to quiet my persuasive, firm voice, as cancer runs strong in our family. Her last checkup was February of this year, and by May the cancer has grown and has leaked into her lower abdomen. The doctors staged her III, which means it has already locally spread. We were all devastated, and I, the doctor in the family, was hit profoundly hard.

She called me today to tell me that her diabetes, which we have been able to tame successfully prior to her cancer, was spilling out of control. With her insulin and medicines, she’s been reading blood glucose levels in the two hundreds, twice that of normal. She would monitor her blood glucose religiously, and would gain a tiny sense of achievement whenever her levels would be normal, or at least slightly above normal. Tiny victories against a disease that she cannot see, and even doubted when I told her about it years back. But today, as has every day in the last week, her sugar is high, and that despite medications. I felt that she was placing a lot into those victories, as her body has not had many during the onslaught of chemotherapy. I reassured her that we can deal with this, that we can gain back the control that she feels she has somehow lost.

I said goodbye sounding reassured myself, but the moment I turned off my phone I felt waves of sadness hit my soul. My mom was sick, and now she also began to feel helpless against it.

I walked quietly, almost aimlessly, feeling tired and somewhat jarred by the phone call. I found myself in the Pedia ward, and I remembered I was really supposed to go there to see my girlfriend and eat dinner with her. I remember a small part of my mind marveled a bit about how my feet remembered what my mind was now too preoccupied to think about, that I have made plans for dinner. I stepped into the Pediatrics ward of PGH, still largely lost in my thoughts.

Once, every visit I had to the Pedia ward was a bittersweet experience. I would see babies, infants, and adolescents struck down by serious disease and it would move me. There was a mysterious injustice to it, something that felt profoundly off and unreal, about children, babies, suffering. I naturally like children, and I am usually not shy showing them that I do, and in the wards with my white uniform I felt I had an excuse to dote on them and touch them. The experience would be bittersweet because for every moment of pain and suffering I would be privy to an experience of heroism and courage, and I would always leave the Pedia ward a bit saddened, but also much more inspired by the bravery of little people.

Today I was locked in my thoughts. Again my feet were moving without my thinking, until I saw a relatively well dressed man standing beside an unkempt young mother and her baby swaddled in cloth, with a tube snaking out of her throat. He was mumbling something, and he was making gestures with his hands. Now curious, I went nearer. His mumbling began to become intelligible, his voice began to be heard, and I made out the words “love” and “child” and “baptism”. I realized that the young baby was being baptized. Her eyes would blink occasionally, but otherwise her body was quiet and remained still.

Tears suddenly and unexplicably welled in my eyes. I was drawn to them, and I stood wordless and tranquil in the noise and confusion of the ward as if inside a pocket of peace with the mother, the priest, and the baby. I was beginning to make out the emotions in my heart, and within my own confusion I realized I was being witness to grace.

I walked away after a while, not finishing the quiet ceremony. It began to feel as though I was intruding upon a private moment, and I respectfully stepped back, and away. Perhaps I felt as if I’ve witnessed enough, seen enough, to be changed by the experience.

I realize that within the oceans of our own despair we are the recipients of grace. I have never subscribed to the belief that our suffering is the will of God—nor our illnesses or infirmities—and instead believe that it is through grace that we heal and recover our wholeness. While suffering and disease are almost never sought and asked for, they become ways for us to experience grace. They were not willed, but they can be triumphed over. Like this child who was being baptized he receives, unknowingly, blessing and baptism. I feel that in the midst of his illness he has been blessed, and he has been reassured that he is loved and being watched out for.

I felt largely re-energized by seeing someone else receive blessing. My mother’s illness—perhaps any illness—feels small in the midst of so much grace. Illness and disease make us feel unwhole and even unloved. There is grace in recognizing that healing can happen whenever there is love.  I realize that it is our task—especially as doctors—to direct grace into the lives of our patients, and to make them remember that there is both grace and love for them, many times unexpected and unasked for, but present nonetheless.

July 8, 2007