Sunday, April 26, 2009

Twilght Of The Damned

Some days, everything you touch, turns to shit.

Or at least it feels that way.

A little knowledge can be a scary thing; a lot of knowledge is often little comfort, either.

Knowing the outcome before you start sometimes don't help anyone much.

When they brought the first in, she looked awful. A short history, of vomiting, was all that was offered. Seen her GP the previous day, and the same GP popped round to see how she was.

I'm not sure how often that happens anymore, but I'm full of admiration for the GP in question.

The home visit anything but homely; patient now in extremis, collapsed, flat out... The Ambos told the rest of the tale: poorly responsive, cool at the edges, papery skin dry and turgid. Feeling for a pulse at the wrist became a fruitless exercise, but a hand over the apex of the heart revealed a rapid, desperate rhythm.

She was sick, sick, sick, and I couldn't help but wonder what secrets her belly might hold. While the team forced fluid into her, squeezed hard, as if somehow this would make all the difference, I laid my hand upon her, gingerly feeling my way around the geography of the belly we know so well.

Willing it to give up its secrets...

Fluids eventually gave her back a blood pressure, and we all looked at the number, and wished we hadn't. Eminent Knifemen passed through and reassured us her belly was benign, that the evil mastermind of these signs and symptoms lay elsewhere.

We found ourselves in a sort of therapeutic no-mans-land. All agreed she was ill; all agreed the bit making her ill was someone else's bit. All agreed she needed agressive intervention; all agreed they would not do it.

I struggle to see the point in half treating someone; death comes to us all, and when we recognise that, sometimes we need to just stop

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