Sanguine

Every patient in the hospital is teaching you something. Sometimes that is the clinical stuff - signs, symptoms and other salient points. Sometimes, it is how their treatment affects them and sometimes it is just the bits of their life story you get by sheer osmosis. Palliative care patients teach you big picture stuff. The value in gentleness. The lengths of sacrifice people go to for partners, parents and the people they love. What a good life and what a good death looks like. Super light, obviously.

The patient I remember most was a 60-ish year-old lady. The summation of a very long battle with cancer in the notes read metastatic cancer, for end-of-life care. She was funny, loved magnolias and hedonistically sweet desserts. She was also ready to die. Sanguine is how she described the feeling.

She deteriorated quickly over the time I was there. Her family started to arrive as it became clear that now was the time. And her family kept arriving. And they kept arriving, and kept arriving. By headcount, there were twenty people with her before she passed. One of her sisters had brought sandwiches to feed a steadily growing army of people who absolutely, categorically adored this woman. She was so beloved her deathbed had to be catered. Her family and friends spent their time swapping stories about her - flipping between giggles, belly laughs and sobbing. They held her hand, kissed her forehead.

I saw what a good death was. This was subserved by the mechanics of palliative care - the medical management behind the scenes which meant she passed peacefully and without pain. Equal parts pharmacology, patient-focused healthcare and weapons grade communication skills. The other factor is the good life that preceded this. If we have to go some time, I don’t know if I could ask for more.

Third Year Medical Student