PALLIATIVE CARE I

It was an early start at the hospice, but the drive there was a pleasant one, aside from a period of what felt like several hours stuck behind a tractor on a winding country lane.  By the time I arrived the temperature had dropped again, and despite the Sun gleaming yellow in the clear sky, the air had an icy chill to it that burnt the lungs.

After sign-in came the MDT meeting where various patients were discussed, all of them just numbers in beds at this stage.  It was the voice of the Palliative Care Consultant, Dr Wells, that rudely snapped me out of the daydream I had been enjoying.

“Right! Shall we go and see some patients?”

“Sorry?” I replied, not having heard.

“Are you coming?” he retorted more firmly, pressing the release button on the staff room door and striding down the corridor.

I hurried after him.  By now I had perfected scurrying around in the shadows of those higher up the food chain and caught up in an instant, pausing in the beige hallway outside Room 6.

“You’re sure you’re OK with seeing this?”

“Err… Yeah, of course!” I replied tentatively feigning excitement.

Palliative care had not made for the easiest viewing thus far.  All the emotion.  All the sadness.  It makes the air heavy.  Suffocating.

“You can come in,” said Dr Wells in a hushed tone from inside the room.

Something was not right.

By this point, I had begun to build up a bit of emotional confidence.  After all, this was final year.  What else could the medical world possibly have in its locker?  As it happens, an irritating habit of pulling something else out of the hat and sending you straight back to square one, parade thoroughly pissed upon.

In the bed of Room 6 lay a lady closely resembling a skeleton; her limbs void of all tone, cheekbones protruding sharply from her cachectic face.  Next to her sat a truly broken man, who must have been in his sixties, clinging tightly to her hand.  He pursed his lips as we entered, the closest thing to a smile that he could muster.  Dr Wells and the man began speaking quietly, but I could not bring myself to focus.  My gaze fixed on the lady in the bed.

She was deeply, deeply unconscious.  Her eyelids rested half open, her eyes seeing nothing at all.  There was a stench of urine in the room that overpowered everything except the gurgling.  That horrendous, sickening gurgling.  Sharp gasps for breath alternated with the babbling of a throat full of phlegm, the surrounding musculature no longer able to clear the obstruction.  It was the kind of noise that made you want to clear your own throat, and after a while, made you want to vomit.

Two young blonde ladies entered, almost spitting images of each other and of their father who sat slumped in the chair.  Until this point he had remained subdued yet composed, but the return of his daughters seemed to stir his grief.

“I’m just…” he gazed around the room, “I’m just really struggling to cope with all this”.  Barely finishing his sentence, he broke down, no longer able to contain his all-encompassing grief.  The gasping inspirations rose to a barking noise, each one cutting the heavy air like glass.

A picture of Jesus surrounded by angels sat on the bedside table.  I found out later that this incredibly religious lady had been diagnosed with breast cancer six years ago and since then it had spread to her lungs, brain, pancreas, bones, left axilla and right eye, just to really take the piss.  For all the angels had comforted her before, in this instant they were utterly powerless.

The rest of the conversation is a blur.  There were tears and hands were held, and then it was time to leave to see the next patient.

The lady in the bed did not cross my mind again until later that evening as I reflected on the day’s events and could not help but wonder if the angels had come for her.

I found out the next day that they had.  She was only fourty one.

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