Meningoencephalitis or on the paper of discharge summary— Encephalitis and encephalopathy.It's not until someone you love has gotten it you start realising how dreadful it can be.
Fear filled every inch of my skin. I had never seen a so-frail dad. He might not be the stoutest, strongest, most muscular dad in the world, but he has always been a father figure, the one who will be hustling to take care of the family if anyone is down. Whenever any of the family member fell sick, he would be the watchdog, making sure things are going okay. But this time it was him himself.
I got very frightened when I noticed something’s off over the phone. I remember crying over the phone, feeling helpless, yelling for help. I begged the sister to page a doctor and order a CT brain. He was not himself, he has got altered mental status. In delirium, he told me that he’s in a hotel instead of hospital.
It was my Birthday. Day 3 of my residency programme.
I managed to pick myself up and continued whatever I ought to do that day. I finished work at 7.45pm following a discussion in CC regarding my research.
The next few days, he has been progressing fast. He has tremors to the extent he cannot feed himself, unsteady gait hence they labelled him as high fall risk and intractable hiccups which means something is going very wrong in the brain. I called to check on him every morning and tracked on his mental status. My heart skipped a beat every time there’s an update from the doctor (or feeling worse if they never give me any update). I can feel my body trembled, feeling paralysed and I was not in the capacity of doing my work.
I feel helpless for the first time. Despite me seeing countless of patients day in and day out in the hospital. How naive was I to tell some anxious patients not to worry too much or wait for an update from doctor without really putting myself in their shoes?
I could not physically be there for my own father. I was worried the doctor might miss things amidst his acute condition despite wanting them to treat him properly—is the diagnosis correct, is the investigation sufficient, is the drug being optimised, is his kidney function okay? On the side note, I knew that there is minimal role for me to intervene. I wanted the best for him, I asked a lot of questions.
On Day 4 5/8/21, I decided I need to return home. It was purely intuitive to do so. They need me.
On the same day of flying home, he was started on IVIG, an expensive medicine that often used as a last resort or salvage in severe sepsis in the ICU or for autoimmune disease. The doctors had no clue what is happening to him yet. The CSF panel showed raised in WBC and protein with PCR E. coli positive, with predominantly lymphocytes but all the other inflammatory markers were negative. CSF culture negative, blood culture negative. The investigation was just not very conclusive.
I have so many questions that I have no answer. And no one can provide one.
He is now back at home, discharged. But i am still very worried. 10 days of effective antibiotics for a real E.coli meningitis poses risk of reinfection. The doctor was telling me that it could be a false positive, that he has been adequately treated from their point of views.
I remain skeptical on the decision, but I know that I cannot force things through. All I can do is hope for the best and pray for his speedy recovery.
My thoughts:
1. The world does not always go as you wish. Things weren’t necessary laid out as it suppose to be. You don’t always get a definite answer. That can be nerve wracking. That may seem unacceptable. There’s a fine line between making things in order tactfully vs. pushing too hard to tense everyone up. There’s a part of you fearing things will go wrong but there’s another part of you who just innocently praying things to be okay. Learning to strike a good balance between staying calm and still in the midst of chaos while keep things under controlled is really hard. Keeping yourself sane and thinking clear is even harder.
2. We should always plan ahead and get the umbrella ready for rainy days. Don’t be like me. Thoughts of whether the insurance coverage is sufficient crosses my head multiple times, I raised the topics before but was oblivious to ask in-depth (because I assume…).Oh well, once they fall sick, the insurance often will come with some exclusion criteria. Getting yourself a good insurance is not good enough, making sure your loved one have good coverage gives you peace of mind.
3. Family is the most important thing in life. For years, this component has been well taken care of and i am really grateful for that.I can now understand how hard it is for a family to go through hardships like sickness. We have to help each other, give the weak one affirmation and give the sick one encouragement. All i hope is that everyone is in the pink of health from now on.
4. We are all dependent of one another. I have received a lot of care and help from my dearest friends. Some called in, some texted. Each of them has given me their love and time to listen to my problem and some have given me very good advices. I couldn’t be more grateful for that. I would be the same for them whenever they need me.
5.For the longest time ever, I am a ‘rabbit’ who has only learnt how to run fast to get to the finishing line. I have my goals, my own agenda and things i wanted to achieve in life. I guess I am lucky enough to be ‘budged and reminded’ constantly by someone who is older and wiser than me. And I am thankful for that.
‘Within each of us there is an Owl, a Rabbit, an Eeyore and a Pooh. For too long, we have chosen the way of Owl and Rabbit. Now, like Eeyore, we complain without results. But that accomplishes nothing. If we are smart, we will choose the way of Pooh’.
6. From the original simplicity comes the ability to enjoy the simple and quiet, the natural and plain and I hope I will always remember this—be it today, the near or the far future.
8. Last by not least, my dear God has never forgotten me in the day of trouble despite me being oblivious all the time! All glory to Him.
Look again what’s important in life. Slow down and look carefully because what is important is often invisible.
Aoran