“Grief lasts longer than sympathy, which is one of the tragedies of the grieving.” – Elizabeth McCracken
My patient died yesterday during my call and all i could feel was sadness and regret. Perhaps regret that i did not break the news as how i would want to break it. Regret perhaps that i went to get some sleep instead of staying with the family while they grieved and regret because while i was pushing a patient from ICU with 100 lines i avoided their gaze because i had a new patient and meeting their gaze would only remind me of my failures to keep their mother alive.
It felt like it came full circle, from her admission into the wards, to again caring for her in the CCU. Her one month stay has touched us all, such a cheerful cute ah ma who watches korean dramas in between her Nebs and antibiotics regime, turning into someone who was bed bound and intubated.
But i am thankful that the few moments before her death i manage to speak to her family x many times, to let them know that she is in pain and CPR was not going to change the management. i felt that we made the right decision to let her go.
Family often feels the guilt of having to decide extent of care, and regrettably us, clinicians, often hold conferences and discussions making them feel that way. “Do you want us to do CPR, do you want us to intubate” “you know her best, do you think this is what she would have wanted” whereas it is only with our guidance and recommendations that families can make such decisions, so i’ve learnt the hard way to tell families our medical recommendation, to relieve them of the guilt they have for not trying hard enough.
“Your mother knows you have fought very hard for her, that you have given her the best possible care, but sometimes even with the best possible care, there are somethings that are irreversible, and continuing on will only lead her to suffer, she is slipping away despite our best efforts, and i am telling you as her doctor that CPR will bring her back only briefly but will not change the outcome”
My voice was shaking and i was tearing, because i could not bear to see her suffer anymore let alone break her ribs.
Sometimes doing less is doing more.
May you rest in peace aunty k, and may your family find peace knowing you are in a better place.
Writted by, Dr J
