At one point my senior colleague ended up unexpectedly off for a couple of months. I had to learn to balance the needs of the hospital against my own limited resources. I started to build up good contacts with local clergy so that they could cover and enable me to take some days off.
One Sunday afternoon I was called by ICU. I’d been there on my rounds earlier in the day and knew there was a very sick patient on the unit so I wasn’t surprised. The man was late 40’s and an alcoholic. He had lots of family around. They had been told it could go either way. I find it much more difficult in those circumstances. It’s easier from my point of view if things are clear cut and I can prepare the family for the impending death.
I spent some time with the family in the relatives room. They had a mixture of religious and spiritual beliefs. Some were obviously uncomfortable by my presence. I offered them a few suggestions of what they might like as no-one was forthcoming about what they wanted me to do. I really encouraged them to express whatever they needed to, to the patient in their own way and I emphasised that I wasn’t there to dictate. I left them with space to discuss amongst themselves what they wanted.
I went back to the nurses station and was chatting to the nurse in charge. She told me that they had just admitted a patient in very bizarre circumstances. The apparent story was that the man, newly married of four months, had got up from the dinner table and said to his wife he needed the loo. When he didn’t come back she went to the bathroom and found him hanging. Even though he was found quite quickly he had done enormous damage and was brain dead. Both the ward sister and I were completely flummoxed by how he could have done something like that in that way. A male SHO was also sitting at the desk and he said he could understand how someone could snap in an instant and do something like that. The ward sister and I decided that men really are from Mars while women are from Venus.
Suddenly alarms started to ring and the patient I had been called to see arrested. I watched as they pumped up and down on his chest. I was very aware that his family were outside. Now, with the experience I have, I wouldn’t hesitate to get involved and talk to the medics and bring the family in. That day, with only just over a years experience I felt out of my depth. A nurse went out to the family and I followed. She told them the seriousness of the situation. The man’s brother went in. I stood amongst the family in the corridor outside. I had the patient’s daughters either side of me pleading for reassurance. I asked them if they wanted me to pray. They all jumped at this. I gulped took a deep breath and hoped that I could pray a meaningful prayer. I then suggested that the daughters went in. I stood at the foot of the bed with the daughters still on either side of me. I put my arms around them. The medics were still trying to resuscitate the patient. They were beginning to look at each other and I knew there was no hope. The medic said “Shall we stop?” The girls screamed and said they had to continue. They did continue and I talked to these young women about letting go and saying goodbye to their Dad. I talked about the suffering he had endured due to his illness and that he wouldn’t be suffering anymore. I could feel the shift in their body language as they slumped more into me. I nodded at the staff and they said again “Shall we stop?” This time there were no objections, just lots of tears. The medics stepped back and I encouraged the family to say what they needed to as hearing was the last thing to go. After a while they went outside. I sat with them and this time they said they wanted to do a goodbye ritual. We waited till the medics had tidied the patient up and then everyone came back in and participated in anointing their brother, father, brother-in-law in their own way and saying their own thing. I felt pleased that despite the initial uncomfortableness at my presence, a barrier seemed to have been broken down. I was with that family for a total of five hours. I hope that in a small way I made a difference.
After the family left I went back in and sat with the ward Sister. We were both exhausted. It was her last shift for a while as she was going on maternity leave. She told me that the family of the other man, who had hung himself wouldn’t give consent for his organs to be used. We both knew that the families wishes had to be respected but we both felt it was such a waste. The man had died in an awful way but his death could have brought life to many others. In the years to come this may have brought comfort to his family. Unfortunately we’ll never know that one and we were all left feeling the futility of it all. What a day!
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