Beginning of the end (My patient has died Part 5)

What would you do if you knew when you were going to die?

Would you live a more organised life? Would you make better decisions? Spend more time with the ones you love and genuinely value? Would you travel the world and explore and
discover more realms of possibilities? Would you take more risks and be
absolutely fearless? Would you write a book and journal more?

Most importantly, what would the dying moments look like?

What would it look like when it hits you that the life you have invested so heavily in, and have learnt to deeply care for, is about to be taken away from you? Would you be prepared to
it let go? Would you be content? Would you be happy?

I guess that’s all we do in life really. We pursue happiness. We want to have it. Having to lose something so precious to us definitely doesn’t make us happy.

We’d rather do all we can to fight to save and preserve it. We will live healthy. We will avoid unnecessary risks. We will pray. We will go to the hospital when tragedy strikes; or even upon the slightest suspicion of its presence.

Happiness would perhaps only come if we had the assurance of losing something so valuable to gain something even better in return.

Perhaps that’s why people
commit suicide and euthanasia. Perhaps this is an effort to get rid of emotional and/or physical suffering in the hope of something better.

Coming back to the spirit of happiness, a close friend of mine once mentioned how she thought that the hospital is such a sad and dull place. She thought it needed more colour, more spice, more life.

Well, maybe instead of hospitals we should have parties. And doctors ought to be trained in the art of disk-jockeying to allow them to give the occasional “Ikibamba sana wapi nduru!” signal to hired
professional screamers. (Translation: If you are on a high, make some noise!)
Maybe hospitals will have some colour then.

But what do doctors do in the wards in the meantime?

Well, there’s plenty of study in pursuit of the healing gem of knowledge. There’s talking to patients to try and figure out what the problem is in relation to the doctor’s amount of knowledge though books and previous experiences.

There’s requesting for laboratory and radiographic tests. There’s the drafting of management plans and follow up. There’s attending ward rounds to assess progress.

However, upon progress towards healing, there is no nduru (screams of
jubilation). Doctors don’t do nduru: at least not in front of patients. They nod in agreement after hearing the words “discharge this patient” and move on to the next patient.

As a third year student in the University of Nairobi, I was excited to wear a red name tag that highlighted my usefulness in performing critical life-saving procedures like carrying patient samples to the laboratory, and fetching patient files from the nurses’ station to bring to the ward round. This was supposed to be
an important step in becoming a super-doctor and I had to respect the process…Or so I thought.

All was ok until it happened. It was one of the most grotesque
encounters I’ve had to face.
An ulcer that had grown so large in diameter on a patient’s abdomen in the surgical wards that I could see his intestines popping out with pus all over. The nurses were daring enough to be covering it. The young man was emaciated and sat trembling under the cold of a chilly morning breeze on an overcast day.

The sliding windows were wide open. He was not talking but he was alive. I was torn between a mixture of compassion and helplessness. I told myself I would have a conversation with him the following morning after he had been attended to, only to find his bed empty. His breath had ceased to exist.

This was the first patient I saw die in the hospital. He had a life. He had a
livelihood. He had a family. He was no more.

Did he know he was going to die?
Did death pay him a surprise visit? What was going through his mind during his final moments on earth? Was he at peace? Was he content? Was he happy?

I keep thinking this aloud to myself as I watch people depart from this world after so much work has been put in to try and save their lives. Sometimes it’s people who are desperately needed in their communities.

They are fathers.

They are mothers.

They are leaders.

They are colleagues.

They are friends.

But we still have to watch as dependants are given room to suck it up and move on. They looked at the
daktari with hope. Now they can barely face him or her in the eye. Fundraisers to settle hospital bills are conducted and people go back to their routines, mostly still carrying the burden of absence and wondering to themselves,

Is there a better tomorrow? Will the pain of losing such a unique individual who was part of my life go away?”

Well, doctors sometimes adapt and learn to view their profession as mere tasks that can either reap a positive fruit or fail miserably: just like any other job or business.

But others see it differently.

They grasp the opportunity to see and share in the dying moments of their patients and watch as they ponder over the quality of their relationships and review their commitment to struggle. They perhaps struggled to find meaning in life. They could have struggled for a cause they believed in.

These doctors would watch empathetically as they look into their eyes that seem to grapple with the tension that lies behind the question, “What happens next?”

By Raysam Baraka