The Final Call: Fading Flowers (My patient has died Part 4)

A few weeks ago, my friend Joy told me that she’s doing a series on death and how we, as medical students, face and handle the death of patients.

When she said so, I paused to think. Have I ever had ‘my patient’ die?

The answer surprisingly was no. Or so I thought. Her question made me reflect on the patients I have met in the wards and how they have impacted my life. With all the cases of death we have discussed with my colleagues, I couldn’t believe none had been mine.

Needless to say, I have encountered death in the hospital. Not only its presence but its impending nature, just waiting to happen.

In my 3rd year, I rotated in the medical wards. Part of the clinical work involved taking histories and examining the patient.

On one particular evening, I casually strolled into the ward and as I usually do, scanned the room for a patient who seemed in good enough health and mood to answer a few questions and examine. I quickly spotted a middle aged man in his late 40s and approached him.

He smiled as I got closer and this caught me off guard. I had not expected to meet a ‘happy person’ , considering the circumstances.

At the time, I also thought that professionalism meant a straight face with an almost sombre look that matches the hospital atmosphere, but nonetheless, I smiled back.

While at his bedside, I was careful to make sure I was on his right hand side(as we are instructed to), gave a brief introduction and sought his consent to proceed.

He happily obliged and I began my clinical work. He had complaints of right sided chest pain with associated difficulty in breathing and hoarseness of voice with long history of smoking.

Before long, I was done. I thanked him and left, having a few differentials(ie possible diagnosis) in mind. Though I needed to confirm the diagnosis, so I looked at his file.

Lung cancer.

The following day, I greeted him, asking how he was faring. This time he complained of right sided chest pain, pointing to that region.

It was clear that the situation was worsening. This broke my heart knowing that this cancer was each day stealing away little of his life. A few days later, he was discharged to continue with palliative care at home.

He didn’t die there at the hospital but however soon after, I know he must have.

On another occasion, I went to the A&E. I was hoping to observe an intubation(this is a whole conflict of its own). I went to Resuscitation Room 1, where people who required specialised medical treatment particularly ventilation support usually are. It’s like a mini-ICU.

Shortly after I walked in, a boy of no more than 9 years was wheeled in. He appeared to be sleeping peacefully. He was not moving and was covered upto his waist with a linen.

I struck a conversation with the paramedic who brought him in. She explained that he had been referred from a hospital in Thika where he had been admitted for the last few weeks. He had not been improving hence the need for urgent referral, due to liver failure.

I asked about his current state and she whispered that he had passed on the ambulance ride. His parents who were anxiously standing outside the room were not aware of the situation. They kept popping into and out of the room to check on him as if they knew but didn’t want to believe it.

Nothing could be done at the time until the doctor confirmed that he was dead. It was an awful situation to be in. Each time his parents walked in to ask what was happening all we could say was we were waiting for the doctor to arrive. I can’t begin to imagine what was going through his parents minds at the time.

After about 10 minutes of waiting I decided to leave. It was too much to take and I didn’t want to be there when the news was broken to his parents.

Death has such finality. Despite the fact that it is certain, the uncertainty of how and when can be really crippling. My conclusion from my experiences is therefore, to make every moment count. To live as one aware of the fleeting nature of life.

As for man, his days are as grass: as a flower of the field, so he flourisheth.
Psalms 103:15 KJV

By Kathleen Kabeu.