THE SATURDAY BIG RE
Rachel Clarke is a palliative care doctor at Katharine House Hospice in Oxfordshire.
When patients are admitted, many are fearful of death. But Rachel and her colleagues are determined to help them live life to the full before they die.
In a second moving extract from her book Dear Life: A Doctor’s Story of Love and Loss, she remembers some of the patients and their stories which will stay with her forever.
DOROTHY
Dorothy was admitted to the hospice on a Monday. “There is no point in spending time with me,” she declared on arrival. “I will be dead on Thursday.”
“What makes asked, intrigued.
She gave me the kind of lingering stare a teacher reserves for the classroom dunce, then explained: “Mr Edwards. The senior consultant on the surgical ward told me my bowels had stopped working and I would be dead in six days. That was on Friday. I have three days left.”
I knew the rudiments of Dorothy’s story. Admitted to A&E with acute bowel obstruction. Given her age – 96 – an almost certainly terminal diagnosis. But at no stage was there mention of Thursday.
“I will concede I do not feel full of death,” Dorothy stated. “I feel full of life. But if you don’t mind, I would rather be left alone. I have little time left and I would like to read my newspaper.”
Rarely in my career had I been dismissed more magnificently. I hardly dared respond.
“Based on my medical assessment, I am not at all certain you’ll be dead on Thursday,” I told Dorothy.
“If you had more time, is there any way you would like to spend it?”
“Were I not to be dead on Thursday, then I would certainly be playing bridge with my local group, as I have done every Thursday for the last two decades. But I can assure you I will be dying instead.”
“How about this,” I proposed. “We plan for bridge, unless death intervenes?”
“Young lady, I will humour you if makes you feel useful.”
A good day, for me, in the hospice, is one in which I feel we have helped someone die with comfort and dignity intact.
But infinitely preferable are the days when we have helped a dying patient live – be that basking in a bath filled with insanely priced bubble bath, stroking the family Labrador, saying a rushed but no less momentous “I do” from a wheelchair decked in flowers in the hospice chapel, or watching goldfinches gleam in the trees outside.
In a ward where every patient has a terminal diagnosis, life, in all its loveliness, goes on.
On Thursday morning, the nurses busied themselves with washing, sprucing, plumping and preening.
When Dorothy finally emerged, dressed for her bridge trip, she could have been Boudicca.
Desperately thin, her chariot a wheelchair, a pre-emptive dose of morphine in her veins, yet nonetheless sitting ramrod straight with crocodile handbag perched on her lap and an impeccably co-ordinated green tweed skirt, cashmere cardigan and court shoes.
Flushed with all the fuss and attention, Dorothy was, for that Thursday only, the queen of our ward – and she knew it.
For a moment, our eyes met, and she nodded imperceptibly.
The next morning, when I you think
WARMTH that?” it
I
Sarrived at her bedside to hear all about her trip, Dorothy bemoaned her poor form. “I simply wasn’t as sharp as usual,” she lamented. I raised an eyebrow. “To be fair, Dorothy, no one else around the table had the excuse that they were dying,” I observed. “Did anyone else seem to mind?” A mischievous grin, a twinkle in her eye, and then, finally, I was liberated from the dunce’s corner with the words: “Dr Clarke, it was magnificent.”
A few days later, Dorothy died. Mr Edwards, it turned out, was wrong by only 48 hours, but in that time, how his patient lived.
SIMON
Simon, a former policeman in his 60s, had retired a few months earlier. Shortly afterwards, he noticed a lump in his neck, painless, innocuous and perhaps, he had assumed, related to a recent head cold.
The lump continued to grow. Still more curious than concerned – he regularly ran 10 miles before breakfast – he visited his GP.
The speed of his referral to hospital impressed him, innocent of the fact he was on a two-week cancer pathway. The scan became a biopsy, the biopsy a consultant, murmuring cryptically about inoperability, as Simon sat stricken, pinned to his seat, hearing nothing of substance after “cancer”.
I heard him before I set eyes on him. Specifically, I heard the sound of air being sucked into his lungs through an airway severely compressed by a tumour.
Simon was sitting bolt upright, eyes darting, his shirt ripped off and both hands gripping the bed like his life depended on it.
Beside him stood a woman in her 30s, distraught and dishevelled, saying, “It’s OK, Dad. Look. Look, the doctor’s here. Everything’s going to be OK now.”
Simon stared up at me, gulping for air. There was no way he could sustain this work of breathing. If, had exacerbated his then I knew how to h
The nurses broug steroids that would, I h the swelling in Simo dose of a fast-acting to take the edge off hi
I saw his daughter S began to describe livi having been widowed “It’s all been so quick. Sophie, if I’m honest, i Timmy, her boy, to loo
“Don’t be ridicu interjected, almost