When I Could Not Answer the Call

There are moments in medicine that remain with us—not because of what we did, but because of what we were unexpectedly prevented from doing. About a year ago, on a Monday morning, I was beginning a week of being on call. Early that morning, I received a telephone call from a colleague regarding a young woman who had presented with a headache. Her brain scan reportedly showed a small amount of subarachnoid haemorrhage. I told my colleague that I would review her as soon as I arrived at the hospital. I had a quick shower and began preparing myself for work. Then, without warning, I experienced an excruciating pain in my lower back. The pain was so severe that I collapsed onto the floor and could not move. While getting ready, I had locked the bedroom door. My wife was therefore unable to enter the room or reach me. For approximately two hours, I remained on the floor in agonising pain, unable even to get to my bedside table where I kept some painkillers. Eventually, as the pain eased slightly, I managed to pull myself towards the bed and push myself onto it. It became clear that I would not be able to go to work or continue with my on-call responsibilities. I immediately contacted a trusted colleague and asked him to take over my on-call duties. I also handed over the referral of the young woman with the subarachnoid haemorrhage. The episode marked the beginning of nearly four months of severe lower back pain. However, three days later, when the pain had improved enough for me to move around, I returned to the hospital to continue my outpatient clinics and review my ward patients. While at work, I met the colleague who had taken over the referral. He told me that I had been fortunate to have missed that particular case. Unfortunately, despite the care that had been provided, the young woman had suffered a devastating cerebral infarction. Her condition had deteriorated severely, and I was told that she might not survive. Understandably, her family was deeply distressed and unhappy with the outcome. This was not due to any negligence or fault on the part of my colleague. It was one of those tragic and unpredictable outcomes that can occur in medicine, despite our best efforts and intentions. At the time, my sudden back pain felt like a calamity. I had been lying helplessly on the floor, unable to move, unable to work and unable to fulfil my responsibilities. The pain continued to affect me for months. Yet, looking back, I have sometimes wondered whether what appeared to be a misfortune was, in another way, a form of protection. We make our plans. We prepare ourselves. We believe that we know where we are meant to be and what we are meant to do. But there are occasions when events unfold beyond our understanding and beyond our control. Only God knows what might have happened had I been the consultant who received and managed that referral. I do not know whether the outcome would have been different. It may have been exactly the same. Nevertheless, through His infinite wisdom, God removed me from that situation in a manner I could never have anticipated. The experience taught me an important lesson in humility. Not everything that feels painful is necessarily a punishment, and not every disruption is merely an inconvenience. Sometimes the event we initially regard as a disaster may carry a mercy that we are unable to recognise at the time. In medicine, as in life, we must continue to prepare carefully, act responsibly and serve our patients to the best of our ability. But we must also accept that we are not in control of every outcome. Sometimes, when we are unable to answer a particular call, there may be a reason known only to God.