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I’m doing a ‘permission to die’ visit at the kind of nursing home we all pray we’ll be able to afford when our time comes.
In fact, on some of my busier duty doc days, when I think my brain will explode if I have to see one more patient or make one more decision, I’ve been known to eye up the corner room rather longingly myself. I could just snuggle up with a blanket on the recliner by the window and stop being a doctor for a few hours. Nobody would notice, I’m sure. The beds look deeply comfortable and the food is to die for.
Back in real life, I’m doing this routine visit. A courtesy call, a quick getting-to-know-you for a new resident so that when the inevitable happens we can say, yes this was an expected death, no need to ring the coroner and get all antsy about the paperwork.
But when I see the patient my heart sinks. She is clearly unwell, and what’s worse, distressed. And she is really, really tiny. A Little Old Lady. They used to say a ‘LOL’ in the days before LOL stood for Lots of Love or Laugh Out Loud.
And she is so very little. So little that even lying sideways across the bed with her feet waving in the air she’s not short of space. So thin I can’t take her blood pressure. So old that she seems more than her 96 years – ancient, wizened, a creature from a Grimm fairy tale.
She’s flailing and moaning and coughing, and her temperature is 38 degrees. Oxygen 91 per cent. Chest crackly all down the right.
Her husband is by her side, sad but unruffled.
‘I’m a little worried about your wife’, I understate. ‘I think she might have pneumonia, and she’s clearly very frail. We should talk about admitting her to hospital’
The nurse looks as if she’s about to have a mini cardiac arrest herself at this and frantically waves a handy advance directive in my face, with a here’s-one-I-prepared-earlier flourish. The husband tells me kindly that his wife wouldn’t want that. There’s not much of her left now, mind or body, and there comes a time… and this is a good place to die.
This all seems fair enough, and I’m doing pretty well with the eminently sensible re-calibration of the day’s activities, when he says something that pulls me up short. I’m still not sure why.
‘She was a doctor herself, you know.’
And suddenly it’s me in that bed.
Felicitas Woodhouse is a GP in Warwickshire and was the winner of the 2016 BMA writing competition. She writes under a pseudonym.
A fortunately good place to die indeed, and particularly in the good care of a good GP who still manages to observe & empathise despite the battering of demands engulfing her. Grateful that to read this , quite keeps my hope up
So true when you step over to the other side of the table and show empathy. You then think differently. What if that was my mum my husband my daughter my son.
I too had a wonderful experience of that with a consultant I had to go privately for my daughter due to a lack of thought from her GP. But what he did made up for it. When the Bill came out he had "no charge" for his service. I wasn't able to thank him until my daughter died of a very aggressive breast cancer. He said he had 4 daughters of his own it could have been one of them. Such kindness is never forgotten.
This is very encouraging as I am a member of Cancer Research PPI Forum Research. So good to see professionals see our side
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