it's a good day to die

Note: Old draft. Written sometime during my Orthopaedic post, between May and August 2011. While on the train journey from Glasgow back to Dundee, I was suddenly reminded of this patient I came across. Was half-surprised to see this uncompleted draft sitting among my posts. Might not be what I intended to write at the time, but I guess I'll just finish it and publish anyway.

--

In medicine, it's not good to grow attached to the patients you treat. But sometimes, there is one or two that would make you smile, brighten up your day when everything else is pulling you apart.

But more so, it's the ones that are slowly slipping away that make you want to hold onto them tight for as long as you could.

--

He stumbled into our busy ward having broken his hip, just like dozens of patients do every week. Broken hips usually mean a death sentence even if they get fixed. These patients are usually elderly, and once they start falling and breaking bones, they lose their confidence, lose their mobility, and eventually lose their independence, ending up bed-bound waiting for the grim reaper. Yes, I sound morbid, but that's the way life is.

Still, much as I am steeled to the cycle of life, it always come as a shock when a patient slips away.

Being cared for by another team, I don't normally see to him and don't know much about him. All I gather from the notes is that he has dementia, and lives with his older brother. The times I actually spoke to him, nothing he says make sense.

I was made aware of him during my week of night shifts as he developed sepsis soon after his hip replacement. We did all we could, which in medical terms meant intravenous antibiotics, supportive treatment, and praying hard.

Sadly, he did not make it through.

It was dead in the night when I had to certify his death. As such, it rests on me to break the news to his next of kin.

"I'm very sorry, but he has just passed away." I said matter-of-factly, betraying no emotion. It was not my first time.
"Thank you so much for taking care of him, doctor," his brother replied through the phone.
"Would there be someone coming to see him?" I enquired.

A pause.

"No, I am his only family and I am too far away to come to the hospital."

I pressed the phone firmer onto my ear reflexively, totally unexpecting the answer I heard.

"It's okay. He's had a good life," said the weary voice on the other side of the phone.

--

I had to gather myself for a minute after I put down the phone.

I don't know you well, but I hope you did live a good life. And you might not be aware of it, but though your brother could not stay by your side, we the doctors and nurses have been with you as you move on to a better place. I wanted you to know you were not alone.

Dawn broke and my shift came to an end. As the sun shone brightly on a cloudless sky that day on my way home, I heard myself thinking, as if hoping he will hear it;

It is a good day to die.