deterioration

i forsee myself writing about death alot.

there’s an elderly patient in my ward at the moment. when i first saw him last week, he was in good spirits eventhough he had trouble swallowing food for a couple of months. after listening to his story, it was obvious that the diagnosis wasn’t going to be good. my suspicions were confirmed when the various investigations done pointed to a sinister disease.

he remained optimistic even as the doctors told him about his condition. the prognosis isn’t good, they said. it is unlikely that surgery will be curative. the man just kept nodding his head and repeating the information he received, as if to reiterate his predicament to himself. he smiled at the thought of getting some palliative treatment that would enable him to take some food…just anything better than the milky substance pumped through his veins now.

but i watched as he deteriorated. he started getting spikes of temperature. he complained of being cold. then, his behaviour became erratic. today, he turned violent, pulling out every line inserted into his blood vessels, taking off his clothes. he kicked at us when we tried to push fluids into his body as his blood pressure dropped.

the investigations couldn’t confirm the cause of his fever or his change in behaviour. he was basically okay…yet getting worse by the minute.

it reminded me of the time when my grandmother was diagnosed with metastatic gastric cancer. she was fine one moment, then gone the next. her disease progressed so rapidly that she died within 3 months of the first sign that something was wrong.

the medical side of me knows that the natural course of her disease was such that it is usually caught only at an advanced stage. but part of me feels that although she was never fully informed about her diagnosis, her body heard the whispered conversations between my aunts and uncles. she knew, subconsciously, that she was going to die…and she let it be.

my patient’s supposed to go into surgery tomorrow. i took one last look at him before i left for home today. he was a pitiful sight to behold: he was restrained to the cot bed, lines on all four limbs, a mask delivering oxygen to his lungs covering his nose and mouth. it was a far cry from the tall (he’s a 6-footer!) strapping figure i said hi to every morning over the last week, the smiling face of an old man who believed he could get better.

it broke my heart.

science says he’s not gonna live much longer. that doesn’t make it any easier to accept.

note: the patient died around the time i wrote this post.

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One response to “deterioration

  1. I hope you will never lose this perspective, after many more years of seeing people with tubes coming out of them, and the visits of death.

    Many doctors deal with this in different ways. Some just become ‘hardened’ and unfeeling.

    On another aspect, I am not sure if having people in their last days with tubes sticking out of them is the best human beings can do in approaching death.

    Glad to see you are writing. Keep it up.

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