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Thursday, July 21, 2016

My Tryst with Destiny - for the second time

 By Dr Nihal D Amerasekera

My first brush with death was as a child when I had a tonsillectomy. I have written about it to this blog some years ago.

My professional life ended in April 2007 with my retirement. I wanted some peace and quiet and time to travel the world before old age caught up with me. I achieved my objectives to reach where I am today. Society encourages us to extend our youth until at some stage our body and mind tells us otherwise.

On the 15th of February 2016 when I was spending time with our elder son in Birmingham I noticed a bit of ‘red confetti’ on the toilet pan which I assumed was the work of my grandkids playing with coloured paper. This happened again in my own home.  I went to see my GP who confirmed it was haematuria. Now the clock started to tick and my journey into the unknown began.  Urologists got involved with a gamut of investigations. The cystoscopy showed a red patch in the bladder and they wanted to arrange a biopsy. By now I had signed the legal papers to move house to a flat in London 50 miles south. I was to stay with my son until our own flat was ready. The Urologist said it was urgent but I told him I am not ready and will get it done after the house move is completed. He wasn’t best pleased.  if it is cancer this has to be dealt with swiftly. I have passed the biblical age of 3 score years and ten, my obligations were done and felt I am ready to unfurl my sails to see the world beyond.

Cystoscopy is a procedure that requires great care by the urologist. There is a tendency nowadays to be blas√© about sterility because of the plethora of antibiotics available. Still there are many who die of septicaemia and infections caused by resistant strains of bacteria. After the cystoscopy I developed the most severe attack of cystitis with a fever, rigors and a painful dysuria of the worst kind. I was in a wilderness of confusion. At no time have I felt closer to death. Passing urine was like cutting the urethral lining with a knife. Luckily  the doctor had given me some antibiotics which took 48 hours to take effect.

First we moved in with our son.  It was more than  a month later we were able to move to our own flat. If I was harbouring a tumour, the time bomb was ticking. I managed to see a GP and get a referral to a Urologist at the Royal Free Hospital in London. I was seen on the 26th of May when they repeated the Cystoscopy. There was no change. Further investigations took a great deal of time and effort. Finally a biopsy was done on the 24th of June. I cannot fault their professionalism, care and expertise. Discussions with doctors about one’s health is never easy. The advice is coloured by the rules and regulations in healthcare, its limitations, political correctness and disclaimers. This makes it all difficult for the patient to comprehend.  I wish I was aware of this in my own professional years. After the procedure they told me it would take 2-3 weeks for the report.  I awaited the results of the biopsy with some trepidation and also surprising calm.

On looking back it is strange to be a patient sitting on the wrong side of the table after being a doctor for 40 years. Diseases only happened to others!! An interest in what lies beneath the skin and behind the symptom has been our concern and now we are the symptom.  I have often wondered when one is a patient if that medical knowledge is a help or a hindrance. On the one hand one worries about the rare complications and unlikely side effects and on the other one is aware of the endless possibilities and how to make best use of the situation and the advice.

The continuous news of death and disease of family and friends are a reminder of one’s own mortality. Awaiting the biopsy results was at times a nightmare. A lot of the time I felt strong and was able to put those negative thoughts behind me. Occasionally I was overcome by darkness and why me and why now? What if it is malignant and required further surgery radiotherapy/chemotherapy. This requires regular visits to clinics with countless blood tests and investigations. Such a restrictive life would never be pleasant and may not be worthwhile. What if it all has spread beyond the bladder and was terminal. Such thoughts did cross my mind. Fear took me to a terrifying place located at the outer edges of human tolerance.  During those times of despair life turns round 180 degrees. Habits of a lifetime of acquiring wealth, gloating on achievements, avarice, greed, hatred and pride – all these things just fall away in the face of death. What remains is what is truly simple and basic. Even current affairs and news items somehow seem irrelevant. The future, the next year and even the next month seem distant, elusive and unreachable. The deep and gnawing pain and sadness of separation from my immediate family was always foremost in my mind.

Why can’t there be a better way to exit this world without all this torment and anguish? I also discovered that eventually one learns how to incorporate death into one’s life. It becomes an unwanted traveling companion that stalks you day and night. At times I couldn’t hide my feelings of utter grief, distress and wretchedness. This must have been hard for my wife to bear. I think finally human beings are programmed to accept the end of life. Then things fall into place and serenity and calmness prevails.

There are many of my batch who have now departed this world. I have often wondered how they coped with the inevitable and what thoughts crossed their troubled minds. I remember the final call I made to “Claude” Bernard in his death bed. He said “ND, I am not frightened to die but wish to live to be at my daughter’s wedding in a few weeks”. Sadly his wish wasn’t granted. His voice still echoes in my ears.

On a fine summers day in July I received a call from the hospital to attend their Urology Clinic the following week. This heightened my awareness of the possibilities but I was able to remain calm.  Being in the waiting room to be called by the Urologist was the longest half hour of my life. I resorted to meditation and mindfulness to bring some peace and serenity to my soul. We shook hands when he gave me the all clear. Immediately I was transported to a blissful paradise and felt young, elated and energetic once more.

This ordeal has changed my life forever. It has concentrated my mind on what is important. Religion has never played a dominant role in my existence except when I was growing up in Nugegoda,  living a Christian life. The ten commandments and the teachings of Jesus Christ gave me a good grounding on how to live my life. As a teenager and later a medical student I drifted away from all this and became an agnostic.  This remained with me almost the whole of my adult life. This last episode has brought me closer to the merits of meditation, the benefit of mindfulness and the virtue of the five moral precepts. The 5th precept however is harder to keep as I love a glass of wine!! I will try to follow the 4 noble truths.  “Nirvana” the elusive state of final liberation from the cycle of birth and death still seems so far away.

The “Mozart Effect” with classical music is tremendously helpful in bringing about peace to one’s soul in stressful situations. Listening to the classics is something that can be done in the confines of your own home. Music of Chopin, Beethoven and Mozart was of great help to me all through my ordeal.

I am the beneficiary of hard work in my youth and have had a life well and fully lived. Despite some disappointments along the way, much to my surprise, I am happy, and often sublimely so. The fine lyrics of that famous song “My Way” does echo my feelings overall. I prefer that 1959 Edith Piaf favourite   "Non, je ne regrette rien",  NO REGRETS.  Shirley Bassey belts it in English with much gusto and feeling. Well actually, I do have just the one despairing regret – not being with my parents in their hour of need at the end of their lives.  I am confident they will forgive me that huge dereliction of duty.


  1. A courageous and forthright bearing of the soul. It is true that when the journey is smooth and beautiful to gaze at while on the treadmill of life, we don't notice the unpleasant scenery on the side and a false sense of permanence and satisfaction pervades. It is always a jolt to the system when impermanence of even the most pleasant experiences dawn on us and the realisation of how alone we really are in this huge Universe. We must aim to gain satisfaction and a feeling of contentment from whatever good fortune we and our fellow travelers experience and may be give some thought to what we got and not on what we haven't. The "elation" gradient is always steeper when the starting point is low and the change is large (basis of "there is no pleasure without pain"). I know of hardly anybody who have the ability to see with their eyes and feel elated and happy as a result but the joy experienced by an elderly patient of mine after a successful cataract operation was amazing to wittness- the gradient was big!

  2. I have realised much of life is an illusion, a mirage and a dream all rolled into one.
    I have stumbled on a topic which is a no go area for many of my generation. It does require some thought. Our lives need some adjustments as we ride into the sunset. Writing a will alone is not sufficient. There has to be some mental preparedness for the final outcome which will make it easier for us and for our loved ones. Meanwhile life is not over just yet and we must enjoy it to the full. Do the things we always wanted to do. Importantly we mustn't be laden with fear or apprehension about the future as we cannot do much about it except what we do to keep healthy.
    I admire enormously the frankness with with Razaque writes about his medical problems.

  3. Dear Nihal, once again you have taken us through a journey, this time, a roller coaster. It felt so real as though I was doing it myself. Finally when then verdict arrived, I congratulated you and rejoiced with you. Your final words 'No regrets' and doing it 'My Way' are real pearls. Thank you for sharing this wonderful true story. Zita

    1. Thank you Zita for your kind comment and sharing my journey. I lost 6 months of my life on the rollercoaster. I hope it has changed me for the better.

  4. My dear pal ND, I do empathise with you and your family at the turbulent time that you and your family under went with this episode of ill health.
    As you are aware I have been through many a tryst in my short life. Most traumatic & uncertain period for the family was when my wife and I had major heart surgery for AVR & multiple bypass within a space of 10 weeks apart!! Following that I've had bilateral cataracts done and have suffered 4MIs at the last count which I think as rather 'minor'!!! Then at one point my son had diverticulosis operated on, while I was in hospital with bilateral pneumonia in the next ward and running a temperature of 41.5 degrees C and delirious and totally unaware & oblivious to my son's plight and that of the rest of the family. At least now I can look back & only shudder at the thought and thank Good Lord--- Allah, for making it safe and good outcome & for making those instances light for my family and me. As you say these episodes have made us understand better the plights of less fortunate folk one see all around us.
    Then there was the saga of my Boobs!!!. That at one point was a very uncertain period indeed though I have tried make light of it.
    I forgot one more instance -- when I was a Little Muslin Boy, had to face up to sharpness of the knife of the guy who took off a part of my anatomy!!! I suppose that happens to all little Muslim & Jewish boys too.
    By the way ND, when you were at your son's place in B'ham & saw those 'confetti' in the toilet bowl... are you sure it was not 'Pol-Kudu'??? I cannot say the same from my experience, as you know I was once a "Little Muslim Boy"!!!!!
    All the very best to you & your family.

  5. Raz
    I am sorry to hear of your misfortunes but pleased much of it is behind you now. Your story is a reminder to enjoy life while we can.

  6. I am using Nihal's Tryst with Destiny to reply to Razaque's comment which really took me through another 'Roller Coaster'! He did all that and finally landed feet first on firm ground. It just shows that we remain what our being is inside us and we watch all these changes happening around us and we are spectators really. It is possible to keep your soul intact and feel relief at the age we are in as we have 'been there, done that, bought the tee shirt-- or whatever, as they say and Razaque and Nihal are as 'happy as a racoon in a baby shower'!! Pardon me, I am only using a phrase I heard on radio. Zita

    1. Yes Zita, ND & I may be "as happy as a pair of racoons in a baby bath" or 'Happy as Larry' now, have had our ups & downs in life. A great momentary blip to me was when an affair of the heart ended... it was not a misfortune but a great stroke of luck, on hind sight!!.
      To me illnesses are not misfortunes... one can get up and go and put it behind you.
      Our greatest misfortune was the loss, albeit preterm, of our Primogeniture, that we still and will forever grieve. This one we cannot and will nor forget, although my moto in life has been.....
      Never look back,
      Never turn back,
      Never walk back,
      Never think back,
      Look ahead.....
      ("walk-on, walk-on with hope in your heart")
      Doing your 'Duty First' the whole world lies ahead.