Saturday, January 29, 2011

redefining hope

on normal night calls, just a glance to check if it's a real plastic IC rather than a photocopied version. but last night i had some time, and was (honestly) attracted to the blue tag to be attached to the body.

so i took a longer look at the photograph. a fine featured lady, with well groomed hair and a smile that radiated confidence and sheer happiness. out of curiosity i flipped open the big blue case file, its thickness an indication of her length of stay.

on the first page, in large clear letters, an order for no extraordinary measures to resuscitate her if she were to pass on. and her diagnosis - which happened to be the same as the cause of death, in as few words as possible (each letter on the death certificate costs money)

subsequent pages in the file were a summary of her condition till date. somehow it was not as medical-jargon-littered as i expected it to be. it started off with her social background - 49 and already widowed a few years ago, with 2 children under the age of 30. a beautician by training. it struck me that the man at her bedside was probably my age or thereabouts. the only difference is that i still felt like a kid while he was a grown person with a heavy load on his shoulders; it's never easy to watch your only living parent take her last gasp of breath. it's never easy to watch the process of deterioration, from fighting a cancer so bravely to stopping all therapy and just waiting and praying for It to be as painless and peaceful as possible. it's never easy to find your world spinning madly out of control and changing forever more.

he asked me if i was here to certify the death. it was the most awkward question because i was the one who was called yet i had no license to do so. all i could do was wait for a senior. he didn't know what i was saying, i don't think it mattered. his mind was overwhelmed with change, it did not matter that i was not the one to pronounce the death.

meanwhile, i went behind the curtains to check for any signs of life. not that i was expecting to find any as soon as i saw the flatline on the monitor. a moment of solitude without her family members who had throughout the night, one by one, streamed in and out. in that minute while i was there, i served no purpose. i could not bring her back, nor could i offer comfort or closure to the family who had their fair share of grief that night. they already knew, they already came to say their peace.

no one had bothered to switch off the wall oxygen, vigorously streaming air into her via nasal prongs, obviously to no avail. it seemed a tragic joke for a milisecond. i turned down the oxygen, and covered her exposed areas with a blanket; the ecg leads were hanging precariously from her unmoving chest as someone had moved the machine and dragged the leads with them. then i looked at her face and startled myself. this was not the woman in the photograph. her left eye was swollen shut, her right eye was fixed, half open, half staring ahead. her frozen face so haggard and sallow it was completely unrecognisable. the photograph did not capture the hours of misery she must have endured, from making the decision to stop her therapy, to telling her children, to accepting death. if at all. her left hand was puffy, and cold to touch - yes i still reached out to pat her hand to comfort her, out of reflex i guess.

i wondered, if she was a troublesome patient and seriously doubted it. their perspective must have been the complete polar opposite from the rest of the patients'. it was just a quiet few minutes of the night call that brought along such reflective thoughts i'm not eloquent enough to put down in words. if you knew your patient only had a limited time and there's nothing to do to stop It, would you still try your damndest to help them? how? by making things easier for them and their families, what with the circumstances, the managing team pulls out all stops and takes nothing lightly. so many people hope to be cured, but special patients these are. they hope to go... on their own terms. no wonder they call it redefining the meaning of hope.

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