Death never quite becomes easier

Why is it that whenever you think of a medical doctor there’s a small part of you that also thinks “wow they must see death a lot, they’re probably used to seeing death by now”.

I have also found myself wondering the same, in fact, I think about it almost every day. Most people don’t spend an awful amount of time thinking about their doctor, why would they? Nobody thinks “I wonder how my hairdresser is doing today” or “have Siya the receptionist put up her Christmas tree yet this year?

I work with a lot of doctors, with many of them I have formed personal relationships, they’re just people after all. I have come across doctors who are professors (by virtue also super-specialists) and doctors who are more than contempt with being a GP. This is a very broad spectrum indeed. All of these highly intelligent individuals will have all, unfortunately, lost patients along the line of their studies and aspiring careers to becoming super-specialists of the anus (when I refer to them as analologists they become quite upset).

Many doctors will tell you that “loosing a patient is a normal part of your practise and the sooner you become acquainted  with it, the better” when asking them about lost patients. This may sound insensitive but when you work in an over-full hospital you cannot take a “mental health” day every time a patient dies. You have to push on, for the benefit of the other patients you have to see. Despite this, there are always patients that just seem to stick with you, despite your drinking, sleepless nights and remorse; hoping that within the dark spiral there may be some obscure form of closure.

I was on duty the one night and the ambulance brought a young male in who was barely conscious and very ill-looking. The concerned look on his sister and mother’s faces spoke a thousand words of worry. I spoke to the young gentleman, trying to get some info out of him best I could, he was responsive but very confused. He was actively bleeding from his eyes, bruises all over his body – almost as if he just came out of a fist fight. The mother provided me with a referral letter from a private doctor (the private sector refers to us when a patient’s  medical aid dries up and they have no more cash to pay for services).

The letter was short, but quite alarming. The patient is HIV+ and is known for defaulting on his treatment, which contrary to popular belief, isn’t a very good thing. He also had kidney failure, low blood cell counts (including the cells that are responsible for helping your blood to clot). The young gentleman also had a terrible history of numerous bouts of tuberculosis. He is also a diabetic. This is a very common type of thing you’ll see in SA.

Something of this patient was different from the hundreds of cases I’ve seen and despite my best attempts at trying to find out why, I couldn’t. Maybe it was the helpless look on the faces of the family members, maybe it was the laboured breathing of the patient… maybe it was because I thought: how could such a young man, with such caring family, end up in such a truly terrible situation. They were scared. I was scared.

I saw the patient, help him with a blood transfusion, spoke with the family and explained that he had to be admitted in ICU. The family agreed, he ended up going to the ward because the ICU was already running at full capacity. I was upset, but eventually got over it and continued with my work.

About one week later I was on duty, with the senior doctor and we received a call from the night staff nurse in charge of the male ward. After the senior doctor put down the phone he looked at me and said “come, let’s go to the ward, we have to certify a death”. On our way to the ward we were making small talk, not even senior doctors like talking about death. I didn’t wonder who had met their demise, after all, I’m only the one going to make sure the patient is dead and sign a form.

It was him, the patient from a week ago. Laying in a side ward, staring with a blank expression at the ceiling. He still had the oxygen mask around his face (the mask that I put on for him a week ago). No family around him. Alone. The window was open and a cold breeze came in. My spine felt like a pillar of ice running through my back. It was him who had died. It is him… it was him. A young man, dead. A person who had a life, who had experiences only he could tell us, a life with love, joy, pain, regrets… all brought to a final point, dead in a cold side ward.

Despite the senior doctor telling me that “don’t feel sorry, he can’t hear you now”. I still said “sorry” to the young man as I took his lifeless hand and hold it for a short while.

No matter how you fast I blink, drink or think… that young man’s death will always be with me.

It’s not about whose fault it was because he was severely ill when he came to us. When I peeped into his chart to see how he was doing prior to his demise, to see what the ward doctor had done… all I saw was a slow regression of his condition. He was too ill to come back, no matter how well we understood his condition, even if we called a professor.

It’s now a few weeks later, and it really never quite becomes easier, dealing with the death of a patient you saw however brief the encounter. Rest in peace buthi. I won’t.




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Please note that key details surrounding both myself, and the identities of the people I mention is changed in order to preserve privacy and abide by ethical standards.

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