One day as I
made one of my regular visits to the ICU I was told of the very sad situation
of a 38 year old woman who collapsed in the street. Her breathing and heart
stopped during the collapse. The paramedics managed to resuscitate her but once
in hospital they realised that she had massive brain damage and was unlikely to
survive. She was not married and her parents were on their way from abroad.
Once the parents arrived I met with them on several occasions. They were
obviously distraught and I spent lots of time just listening to the mum sob. It
was an awful situation for everyone.
The young woman
was moved from ICU to a ward and everyone knew it was only a matter of time.
The palliative care team had become involved and had written up medication to
help with the fitting that was occurring as well as the usual end of life
medications.
The young woman’s
dad was a very contained man and didn’t say much. The mum opened up to me more.
They were always very polite and appreciative of my visits to them and their
daughter.
The young
woman died in the early hours one day. I became aware of this when I bumped
into one of my palliative care colleagues in the hall. She told me that the
parents had been unhappy the last day about medication and it seems there was a
problem with the ward not necessarily following the instructions given by the
palliative care team. I am well aware of the difficulties that can arise due to
communication not being carried out effectively and kind of inwardly sighed at
this added difficulty. I said I would ring the parents the next day to give
them a bit of space from the awful immediacy of their daughter’s death.
Much later
that day after most people had gone home my palliative care colleague phoned
me. She said “Thank God you are still there” She sounded really shaken up. The
woman’s mother had phoned her and screamed and shouted and sworn at her almost
hysterically for half and hour. It seems she was holding my colleague
responsible for her daughter not having a peaceful death. The mother would not
accept from my colleague that she had written up all the medication that her daughter
might possibly need and that there was nothing further that could have been
done.
I really felt
for my colleague. It is extremely hard to have all that raw emotion aimed and
thrown at you and still keep a professional view of the situation. My colleague
had started to doubt herself. I was able to reassure her that she had done
everything possible. We then talked about this being an extreme grief reaction
and then did a debrief. I told my colleague that I would ring the family and do
any follow up needed. She warned me not to ring that night. I told her not to
worry and to go home and have a nice glass of wine and that I would ring her
and the family the next morning.
When I spoke
to the family they were obviously distressed but were calm and coherent. It
seems my colleague had born the brunt of it and they were now able to be
rational again. I offered the family on-going support and said that if they
needed any advice to let me know. I was acutely aware that they were not in
their own culture or familiar surrounding. I also know the death is a
bureaucratic nightmare. I encouraged them to ring me at anytime and said I
would also ring them from time to time.
I didn’t hear
from them for a few days and by the time I got to ring about a week had gone
by. They told me they had arranged their daughter’s funeral for the next day
and said I was welcome to come if I wanted. I asked them who was taking the
service for them. They said no-one that they had just invited all her friends
and hoped they would all say a few words. My stomached flipped as they said
this. British funerals just don’t work that way. I said I would come to the
funeral and that I’d see them in the morning. I then desperately searched for a
few meaningful poems before I had to dash from the office for a meeting.
The next
morning the woman’s friends gathered at the crematorium. The parents said a few
words about their daughter at the beginning and thanked everyone for coming.
Her dad then told us about the kind of child this young woman had been and how
proud he was of his daughter’s achievements. He then said if anyone else wanted
to say anything he’d like to hear from them. There was an uncomfortable
silence. I got up and explained who I was. I read a poem and then said that we
weren’t used to getting up and talking at a funeral but it’s good to have the
opportunity to say a few words about the person who had died and what they
meant to us and share memories. I sat down then a man got up and spoke about
his debates with the young woman and how they always laughed together. He sat
down and then there was the uncomfortable silence again. Eventually the dad got
up and said he didn’t know what else he could say but that his daughter was the
best person she could be. He started to choke on his tears so I went and stood
beside him. He gratefully glanced at me and went and sat down. I read another
poem and said people might like to share their thoughts with those around them.
Again there was an uncomfortable silence. This time the mum got up and thanked everyone
for coming and asked me if I would say a prayer and finish the service.
I normally
think about what I am going to say for a week at a funeral. I take longer to
prepare for funerals than for sermons because I think it is so important to
give someone a good send off. Here I was, standing in front of everyone, with
no notes and only a few moments notice of having to say something. I think what
I eventually said was appreciated and I was fortunate to be able to recall
words that I have used in similar circumstances but I didn’t like it and the
experience left me exhausted.
The family
came to see me a few days later. They left me a card which had these words
inside; “We’d like to thank you for all of your help and support – it was a
real comfort to us. While we thought we could ‘go it alone’ your presence at our
daughter’s funeral aided us so much in getting through a most difficult
time. We wish you a happy and fulfilling future. We’re sure that your
compassion and understanding will continue to help many people. We hope that
you derive much personal fulfilment and satisfaction for all do for others. You
are a truly special and compassionate person.
The enclosed
is for you to do with as you wish – charities, etc. it is a very small token
of our appreciation”
Inside the
card was £100. Sometimes it is impossible to gauge the impact of an interaction
and what different people take away from these tragic situations. I will
treasure this families comments and feedback. The money I gave to our
chaplaincy fund from which we do an annual memorial service for all those who
have died in the hospital. I wrote to the family and thanked them and said I
would remember their daughter at the memorial service even though by then they
would have returned to their home country.
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