Meaningful life and death – Losing a Patient

I’ll never forget the day I lost my first patient.

Even though she was drowning in her own secretions and it was an effort to say a single sentence, she managed to mumble the few words, ‘I want to walk.’

It was my third week at that particular clinical rotation and I had been seeing this patient who was diagnosed with XDR-TB. She was tiny, skin and bones and as light as a feather that I could pick her up and put her in and out of her wheel-chair by myself. Most of time, she would just be lying in her bed, oxygen mask on and would turn her head away as soon as I entered her room.

Due to her condition, I was performing chest physiotherapy – and she hated me for it. She would scream and moan and wish me away. Until one day she said to me, ‘I want to walk.’ I was quite taken back by this request as she despised treatment sessions but I jumped at this very rare case of motivation.

There she was, up and standing, myself holding her at her side, and she took one little step, and then another, and then soon we were walking. Patients in her ward looked in astonishment, but then soon encouraged her by applauding and calling out her name. The biggest smile appeared on her face – this was the first time I had ever seen her smile.

Even though we only walked a few metres, she was so happy and thanked me profusely. I helped her get back into bed, and because it was a Thursday, I said my goodbyes and said that she must have a good weekend, and I’ll see her on Monday.

Monday came and I was searching everywhere in the ward for her file. I asked the sister on duty if she knew were the file was, it was then that she pulled me aside and said that my patient had passed away in the early hours of that morning. Immediately a feeling of shock and self-doubt came over me.

With regards to our profession, one cannot become attached to patients and we have to develop or learn to develop certain coping mechanisms to deal with such situations. For myself I chose to ‘not feel,’ simply because I felt like I was not allowed too. According to Reynolds (2006), physicians deal with difficult situations by externalising the problem or by becoming a little numb.

Perhaps one could say that I did become a little numb by choosing not to feel, but I was also angry because that day gave me so much hope as I was finally seeing an improvement in my patient– but unfortunately I didn’t know that the first time I saw her smile was also going to be the last.

References

Reynolds, F. (2006, September). How doctors cope with death. Archives of Disease in Childhood, 91(9), 774. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2082912/

 

 

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