Of all the firsts that I was looking forward to as a junior doctor, the first time a patient that I cared for died was not of them. I always knew that this day would come and before I went to medical school this fact was the thing that put me off the most. How would I cope. If you know me you knew that I wear my heart on my sleeve and things upset me. So of course this would too.
Recently during a 12 day stretch at work I had this experience.
The patient was in their late 90s and was for their age, quite fit and well. I clerk them in and when I went back to see them a few hours later they look terrible sick and I called for help. It was likely that this patient would need an operation but given their age they wouldn’t be able to tolerate the anaesthetic.
I sunk back in my chair while my seniors called family members to discuss DNA CPRS and explained the gravity of a the situation over the phone. It all moved in slow motions for me. A few hours ago I was talking to this patient who didn’t look too sick and now all of this was happening.
My seniors all delt with it better than me. I was trying not to cry and they were talking about the next patient who needed to be seen. It’s not that they don’t care. They have just done this before, and knew how to del with it better than me.
Whilst we waited for the results of the scans we had ordered, we moved on to seeing other patients.
A few days later, we had excluded our initial thoughts for this patient and they were on a ward looking much better. I was optimistic but my seniors had seen this before. This patient was likely going to die.
A fews days on the ward and the patient took a turn for the worst. I spoke to the specialist for this patient and they agreed comfort was the aim. Time to write up anticipatory drugs and call the family over the phone to come in sooner rathe than later.
Two firsts for me as a doctor.
When the family came in my senior took over. My contribution was to sit in the room and hand over a tissue.
At the end of the day I went to see this patient. They looked strangely peaceful with the light of the moon shining on their face. They had a fan on them and had drifted off into what looked like a peaceful sleep.
The next day at work I went to see the patient before the ward round and was told by the nurse looking after them that they had died in the morning. They hadn’t struggled and it was a good death.
When I wanted to be a doctor, I wanted to help people. I wanted to save lives. Beat disease. Cure stuff.
I still want to do all of those things but my outlook is changing.
What will be will be. All you can do is try. And my God will I try for my patients. But survival is not the only success. Sometimes a good death is the success. Like for this patient.
No one failed just because this patient died.
Helping someone have a good death is just as helpful as treating a stroke. Death per say isn’t the enemy. A bad, unnecessary, preventable death is.
It’s still early days for me with this doctor jig but I’m glad I get this now.