Let's do the last dance in style and with dignity
I remember fondly of this patient who was admitted to the subsudised ward that I was covering. She was a peaceful looking old lady. While all the old ladies in the ward often scream and shout of pain and giddiness, there she was, so quiet and serene. She was post stroke and not only was she not able to verbalise, she was unable to move all 4 limbs.
The first time she was admitted, we were pretty amused at how much she looked like Popeye. She had this little tube inserted by her family into her left nostril. Her nose was pretty flat and had sort of collapsed and her family was worried that she could not breath properly. With her small little eyes and the tube sticking out like a pipe, the resemblance was uncanny. We meant no disrespect giving her this nickname. Humour is just one of our defences against the cruelty of life.... and death.
On top of the stroke, she also had generalised eczema. Her skin became thin and papery, a light rub and it broke and bleed. It was literally crispy! Her skin condition was so bad, she started developing sores on her buttocks. The sores got infected and we treated her with strong intravenous antibiotics. Everyday, it was a struggle to find a vein to insert the needle. Sometimes we had to poke her 4-5 times before we can get an IV access. All this time, she was quiet.
As the doctors were worried that her family were unable to give her proper care, she needed to be turned every 2 hours and her sores need to be cleaned and dressed twice a day, she was discharged to a nursing home.
Few weeks down the road, Popeye a.k.a. Crispy was again admitted, her sores were now so deep and extensive, you could see the gluteal muscles underneath. Again the sores were infected and we had to give her strong antibiotics. Each day we had to look for that elusive vein where we can insert the needle. Soon she had blue blacks all over her limbs. All this time, she was quiet.
We asked the family how far they would like us to go, how far they wanted us to go to save her life, how far they wanted us to save her life so that she can suffer some more. It took them many more admissions to decide. All this time her sores grew deeper and bigger. Finally it hit them that all we were doing was causing her more pain, to extend her suffering. Her family decided that treatment should be withdrawn. Few days later Popeye a.k.a Crispy passed away. She looked so peaceful and serene. Unlike all the other patients, she never complained about pain and giddiness. She was quiet.
agree to what u have said. Sometimes when i see my patients i'm wondering am i saving them or extending their suffering.
ReplyDeletei guess your caring profession makes you numb and devoid of feelings after a while, no offence intended. As much as you wish to end the suffering of patients, who are we to decide for them, especially, those who can speak? like the old lady? What if they still want to live and prolong their lives, despite the suffering? How do you decide on such issues? God gives us life, do we have a right to take it away? I am still struggling with myself when i let my brothers decide to tell the doctors to stop all treatment for my late father. What if.....
ReplyDeleteYeah.. that's why i always tell my father that i'll take my chances with the cholesterol... 50% of AMI die on the first attack. Between that and cance, well...
ReplyDeleteTo Jusme:
No offence intended,and not much recieved, but i think your comment shows that
a) you're not a doctor/ health professional
b) dont really understand the situation and people that run hospitals everyday.
My father who's a clinician in his 50s approaching 60s still remembers the first patient he lost. So yes he cares, and I daresay a lot of other docs still do. But as a doc you wouldnt be able to function everyday, if you showed everybody the kind of "concern" that only a child could (and should) show his parents.