How I got to this point - Remembering the Future
Story # 1
THE GODDESS AND THE TOMATO SKIN
It was the biology class, 8th grade, primary school. Memorising evolution trees, dinosaurs names was tormenting for me. That day the Teacher started the lesson placing a tomato on the her desk saying: “we will deal with the tomato skin today”. It was provocative… Up to this moment a tomato skin existed in my perception as a tomato container. A woman in my distant family had been warning me to always peel off the skin before eating it, since it may attach itself to my gut and cause some trouble. Anyway - “tomato” meant the juicy thing inside. Skin was meaningless. She divided the class into groups of 3 and took us to the other room where 8 microscopes were standing ready for taking our gaze in. The quietness of the room, symmetric microscopes set-up, sharp light focused on a tiny area - it all reflected a shrine-like divinity in my consciousness.
After instruction sharing the Teacher invited us to observe. The world outside the optical line of the microscope got lost for me. I don’t remember anything/anyone but the moving micro-picture of tomato skin cells, me being suspended in a flow state and the Teacher being present. This was the last class this day. It finished at 4 pm for all except me.
At 5:30 pm a feathery, feminine touch on my shoulder paired with my name whispered invited me back to the reality: “Rafal, the class is finished; I have been staying with you here for 1,5 hours; we have to leave; the school janitor will close the doors soon".
I asked for 10 min. more. She said “yes” with a fairy smile. I got back the tomato skin trying to decode the pattern of circular plasma organelle movements around the nucleus.
The Teacher - she will always be one of goddesses who shaped my approach to woman. She gave me space for my passion forgetting herself. I am trying to give it back to this world ever since.
Story # 2
THE DEAD MAN WARNING - DEATH DIGNITY
Medicine was my passion. I had felt like Sherlock Holmes decoding patterns of nature, getting to the why and the how of life. Preparing myself to the entry examination at Wroclaw Medical University was hard - I devoted all of myself into it. First, I drafted the prep plan - 3 weeks allocated for the 3 main subjects (biology, chemistry, physics); 1 week per subject then one week for synthesising, rehearsing everything. After the examination , when I came to find myself on the list the candidates were displayed in order of points earned. I chose to start my scanning from the bottom - checking names of those who didn’t make it. The failed list was 3 times longer than those who succeeded. Did not find myself there. Then, driven by a spark of hope I jumped to the “Passed” list and started from the lowest scorer. There where hundreds names altogether. This was intense - hot day, joy and sadness, disappointment dancing together in vigorous squeeze limited by Times New Roman 12 fonts visibility. I got tense - no trace of my name and I was approaching the second hundred, then the first hundred, the first fifty… was pushed away by the crowed for a moment… got back. Finally spot it and froze in an awe - I found myself on 20th place out of hundreds of applicants. Later I learned that most people in the first hundred used payed tutoring on all examinations subjects. Being aware that I have never used payed tutoring a shadow o pride befriended me for a while.
The first and second year passed with ease. Most examinations, including the King - the Human Anatomy I volunteered to be the first student to pass - before the official exam session date. I needed no prep since my passionate curiosity fuelled the drive to study everyday, on the go - born out of the need to decode the nature patterns. Pathology was at third year. Everyone waited for it - we were to interact with the death - the deceased human. Pathology was perceived as a “real subject” dealing with direct causes of human body to die. It was Sherlock Holmes ethos rediscovered for me. Examining a dead body to confirm or refute the original diagnosis formulated by a Doctor who treated the patient personally was a puzzle nowhere to find. The Doctor was often present at the autopsy session what was potentially disturbing since 30-40 students witnessed it, watched every cut and processed every ward. This was something - my passion hot and radiating like a fluid metal. One of the “heaviest”, content-reach subjects passed like a mosquito flying by. Again, I enlisted for the earlier possible examination date to the iconic and widely admired lady professor - the Pathology Cathedral Head.
I passed it without a single flop. After 30 min of extensive questioning the Professor started to discuss Pathology role in Medicine with me. She offered me an Assistant position in her Cathedral when I finish studies in 3 years.
3 years later I was working there. I did lectures for the whole year students population - 300-400 souls and research autopsies for students groups at the operational theatre. Befriending death, touching the core of nature and human dignity in the name of science was a monumental and transformative experience.
Franek was responsible for autopsy fridges at the autopsy facility. I respected him and he knew it. I spot an opportunity to learn more. My personal vision at that time was to become a neuro-surgeon specialising in brachial plexus reconstructions after traffic accidents.
I volunteered to the Trauma Clinic and assisted in emergency operations/interventions at weekend 24h shifts. I dreamed to be the best; decided to connect both worlds - learn on the deceased to save mistakes on the living people. I asked Franek a favour one day: “Could you get me a hint when there is a body in the fridge that no one claims ? I want to perform a specific neuro-surgery operation to learn”. Franek was a simple man; he trusted me; said: yes. We agreed a plan. Franek will inform me that there is an opportunity, set a cadaver in the dissecting room and close the whole facility. I will appear there late in the night to do my surgery.
These were the dark times for science in Poland - no or very limited access to international research, modern handbooks. The only way to get access to the up-to-date research was via “book charity”. Medical University library was getting specialised literature from “the West” - USA, UK periodically in ridiculous amounts - a bunch of randomly selected books had been appearing every 2-3 months. I was a frequent visitor there befriending the all-female librarian team; spending 2 Saturdays a month there studying research papers in the reading room, exchanging smiles, small talks before and after. I asked one of the librarians to retain for me any american surgery related books coming. She did it. I got access to a brilliantly illustrated edition of a handbook for plexus brachialis surgeons. Grabbing the book for the first time and paging it like crazy in the tram going back home - I was in heaven.
The plan was launched. I started my own way of preparing to be a surgeon. My “How?” was simple: “before cutting flesh of a living person - do it multipple times on a dead one. Every week or two you could had found me as the only person in the murky, old, cold century old brick building with yellow, spotty lighting, smelling death - the last sensation unforgettable for life.
The scariest thing was to get to the autopsy room and the wrap up after; between - the pure passion burning and the feeling of mission fulfilled. At those moments there were just 3 elements in the universe: the book - opened on the specific reconstruction surgery procedure page, me and the cadaver of infinite patience. I dissected tissues, got to the nerve, cut it and started my reconstructive surgery unattended by anyone; usually it took me 2-3 hours to complete the reconstruction and close the wound.
To get to the dissecting room I had to open the main door first. It resembled a church main entry portal. You had to use a huge, 12 cm long key, then climb 2 flights of stony, polished by thousands students stairs, to get to the Pathology Department floor. I had to pass 30 meters long corridor. To to get to the light-switch at the end, in total darkness, I had to use my hand sliding on the wall as a probe. I knew a cadaver awaits me in the autopsy room. The fear was like a wet, sticky, heavy blanket enveloping my body, my consciousness; every single thought was wrapped in it. Getting out after this was even worse. The sequence was reversed: light off and getting back with a weird feeling of guilt flirting with dignity of death - the cadaver resting after my surgery meters behind my back. My brain was testing every random sound against an imagined pattern of him raising and following me.
One night after an operation I got home and fell asleep. This night will stay in my memory for life. 30 years after I remember every second of the experience. This proved to be pivotal for my approach to medicine learning. The cadaver payed me a visit. The dreamed story was a copy-paste one of the regular experience but… with a little twist.
I got to the building, opened the main door, climbed the stairs, passed the corridor to get to the light switch, lights on - straight to the changing room. Got changed and… before entering the autopsy room I decided to use the toilette. There were 2 doors. I grabbed the handle on the right trying to enter. It didn’t let go. There was a rubbery feedback to my pulling - I decided to overcome it; used all my power to overcome it… the door got released. On the toilet seat a creature was resting - naked, bloodied, front chest wall missing, no internal organs. The head, shoulders, pelvis, hands and legs were fully functional, moving, eyes open; skin light grey. He was lighting fast - grabbed my collar and started pulling with an off-road winch power - slowly centimetre by centimetre. I tried to brake the grip - no way; this was unstoppable, my face moving towards his face; the pull stopped at 5 cm distance. He was staring with milky pupils straight into my eyes. No movement, no breathing, silence.
He said: “I’ll do to you what you did to me”.
I was awake and sitting on the bed in a split-second. Heart rushing, sweating cold. Never did the “operation” on cadavers again. Human body as an ultimate expression of creation will always stay as a monument to admire and protect for me.
PRISON - THE POWER OF HUMAN DIGNITY
I have always been fascinated by prison psychology. What really happens when people are confined to exclusion, how the prison society moulds personalities, is it possible than people can be bad to the bone?
I applied to the biggest Medical Unit/Prison Hospital in Wroclaw, signed some papers and was sent to 2 week preparation training - a kind of a boot-camp. The only thing I remember from it - “never drink anything from a glass while meeting prisoners”. Why? because they may grab a glass by the bottom, hit a table ridge and pump it into your throat. The chances of survival are near zero. I came back and got assigned to the most gruesome unit in the prison. Home for hardest and repeated offenders. One third of them will never get out of this place. The inside was familiar - we all saw it in gruesome movies - 3 floors, steel stairs, nets preventing falling down, multiple cells, solid-steel doors with tank-shaped peepholes. In the geometric centre of the building there was a Medical Unit/office - my workplace. I was to admit patients there 2 times per week 900-1300. The Unit consisted of 2 rooms: waiting room and the other - physician’s office. Both rooms were adapted prison cells - the same dimensions. There was an additional door linking both cells - to get from the waiting to the examination room there was no need to get to the main hall.
A prisoner’s right was to have unlimited access to Medical Doctor. Enlisted, a prisoner had a relatively safe time - first in the waiting room - under direct supervision of a guard, second - during the visit. I was supported by two highly qualified nurses with 10+ years experience in the prison. This was my “first day in the office”.
I was sitting in the Doctor’s chair which was remarkably different than both nurse’s and patient’s chairs. Doctor’s had wide arm and generous back supports, soft seat; nurses' were built out of a profiled plywood, patient’s was a metal stool, painted white, height regulated by rotation. Kate - the senior nurse - spotted my nervousness, gifted me a sweet smile and said: “whatever happens we will support you, Doctor”. I felt reassured. Kate raised and knocked the door separating us from the waiting room -signalling readiness. After a loud metal shuffling the guard opened the door wide. The waiting room was substantially darker than my office so I saw a raw of uni-coloured human shades sitting on the bench. Someone raised and approached the aperture. The patient was huge. Trying to enter he stopped right in front of the door frame - his head and shoulders loomed well above it. I am 193 cm high and was crossing the same size doors with a slight head nod. The width of his body was denying him access too. Pole (his pseudonym), to enter, had to rotate sideways and tilt the whole body to enter. He did the exercise, entered and got upright like a medieval warship captain - his legs spread, chin up - trying to impose his greatness; shirtless, world history tattooed all over his body. He was “the King”. Pole decided, that he has to "check-out" the new Doctor as the first patient. All safety warnings & advices flashed across my brain. Every atom of his presence communicated to me: subdue and align or have trouble. I got calm and intuitive; raised from my chair, approached him, shook his hand. The hand was monstrous in size and shape - the guy spend 20+ years in the prison gym pumping raw steel. I have never seen a body outline like this. I said: “Good Morning, you are my patient. I don’t care why you are here - I am here to help you. You are important for me. Please choose your seat”. I made clear that my chair and his stool are the alternatives. His bellicose approach dropped like a clay vase to the stone floor and crushed - disintegrated. His face changed - from a stony warrior to a teenage boy lost in a dark basement and saved by a caring parent. He couldn’t move, tearful eyes starring at me. He mumbled: “how come? I cannot sit on the chair - this is yours; I insisted: stool is ok for me - you are the reason why I am here - make your choice. He was shaking. Took the stool finally. We had a great conversation. After it “The King” raised, approached me and whispered to my ear: in case of any trouble, Dr, just let me know - I am the King here. I had been working there 6 month. The King had been enlisting always. He was regulating the flow of patients between the waiting and examination rooms. Anyone who entered had his goliath hand on the neck and lips pushed to the ear whispering: “Hey, this is the Doctor I told you about - respect him or we’ll have a chat after”. Each patient was scared shitless; some were shaking and couldn't calm down or talk.
The discipline was just spectacular.
Dignity changes people, breeds respect, makes peace. Dignity changes people for good.
The system denied Pole dignity - so Pole built his own system.