Friday, December 21, 2007

(She Acts Like We Never Have Met)

Be careful what you wish for.

First, the suddenness of disaster.

Patients who I see probably give me an unrealistic idea of how ill prepared we are for the end. Our patients are subject to an inherent selection bias. It isn't a true representation of the general populus. I guess. Or that could just be arse.


What I mean is that we often see people at the 'end of life' with diagnoses that seem terminal. It's often those who have a recent diagnosis. So, suddenly, you go from being healthy, to having lung cancer with brain mets. It must be hard enough breaking this news, without having to discuss the imminent prospect of death.

And so it falls to us.

A gradual deterioration - 'he's not been very well today', then, in a flash - 'he won't wake up'.

And so it falls to us.

It's in the eyes. I see it in your eyes: willing us on, willing us to fix it, to do something, anything to buy a little time. I see it in your eyes: they're blank, staring, unfocused. Windows of the soul? In your case, they let me into your skull, warn me of the pressure within. Straining to get away.

An escape we both know isn't possible.

A review of the notes tells me all I need to know; talking to the family, it seems obvious to me that this thought has not been allowed to take hold. They must know it's coming; but not now, surely.


The CT confirms what his eyes had told me. Bleeding everywhere, pools of angry white on the scanner. Tortured brain struggling to cope. It won't be long now.

And so, finally, it falls to them.

No comments: