Fri, Dec

Pushing on. Photo - JAMA Network

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Two weeks ago, in the shadow of the Tower Bridge, I spent 3 days with extraordinary people dealing with extraordinary challenges. I have been for a few conferences tackling neurosurgical topics, but this was the first time I shared the room with so many people who had been on the other side. The other side of my consulting desk. The people who go home and deal with the diagnosis the doctor gives. The people who have to take the medications, and suffer the side effects we tick off in answering our exam questions. The people who have to live with the benefits of good judgment, and the horrors of a surgical mistake.

The challenge of the brain tumor, is that so much work has been done on it in the countries that care about health… but the survival is still not much better than the countries that don’t. The quality of life however, is very different. And the future holds much more promise, in the countries that care.

I had the unfortunate task of talking about the spectrum of care and scope of disease in my country. Unfortunate because I had to speak after someone who had elaborated the excellence of brain tumor care in a Scandinavian country.

Of course I did not mention that in entire regions in my country, there is no capacity to image the brain. I also did not mention that most of the neurosurgeons in my country were concentrated in 3 regions. I almost mentioned that my country had given up on training any more neurosurgeons, and had ceded that responsibility to the magnanimity of district hospitals, which are not interested in sponsoring a doctor for 7 years, but I didn’t. I did mention that we had National Health Insurance, but that it covered only infective diseases and some trauma, and no tumor care at all. I also mentioned that we had 5000 doctors, with 1500 in public service with hundreds waiting at home for employment. I did not need to be too exact. They got the general picture.

They had been dealing with impossible situations on a daily basis. Suddenly talking about the overwhelming burden of trying to be relevant in an environment unused to real medical progress, I was in good company. These were people either fighting cancer personally or holding a friend’s hand, a relative’s hand through it. They were people used to fighting impossible odds, and winning. And when they lost, they had been preparing for that all through the battle. That did not take any of the hurt away, but even the hurt was channeled into fighting new battles.

And that was why there were so many people around me who had lost a lot, but had made so much of their loss, I did not feel like I had anything to complain about. When one looks into the eyes of someone who has watched his daughter die, it is impossible to talk about a country refusing to help itself. Tragedy had fueled so many brilliant victories in the room, it seemed a necessary ingredient for anything great.

I came back home with a lot on my mind. A deeper understanding about the struggle in the families that cope with the scourge of ill health. A deeper commitment to listening to their voices, and tapping on their strengths. An acceptance of the fact that sometimes the solutions do not really lie with institutions, but with people who do not give up. That sometimes success thrives only because people are not fazed by failure, after failure. A renewed hope in the beauty of the human spirit. That sometimes just looking out for each other is all we need to go forward.

A brain tumor patient, sometimes gets an estimate of how long he or she has left. Sometimes its a few months. I met people whose months had stretched into years, and they have no plans of giving up. Ultimately we can only live one day at a time. Sometimes the victories come from making the most of the day we are living.

Settling back into the routine of the land where living is dying slowly, I am reminded to take one day at a time. I know that if I got a tumor, or got a severe head injury, I would have no chance, I would depend on a miracle. I still have to live one day at a time.

And make the most of it.


Dr. Teddy Totimeh is a neurosurgeon by profession and an avid writer. Several of his writings are available for purchase on Amazon.


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