I work on geriatrics. I previously worked on oncology/haematology, and then surgery. It will always be somewhat unsettling, but death is an intrinsic part of my working life, and certain aspects of it, Iâve grown accustomed to.
This was different, though. This was a ball on the weekend. I took a taxi there, and the taxi driver asked me, âSo...whatâs the event? Someoneâs birthday?â
I had no idea how to describe the event I was going to, but it felt like the opposite of that.
I looked after her a long time ago. She was my first patient on that job. She was the only patient who was there for my entire tenure on the haem/onc ward; following chemotherapy for her leukaemia, she was neutropaenic, with her bone marrow obliterated and her body unable to mount any sort of immune response. Every time she looked like she was improving, another infection would rear its ugly head and sheâd be dosed to the eyeballs again with heavy duty intravenous antibiotics. Despite this, she was always spirited, and always found something to laugh or smile about (at the expense of my consultants, wherever she could manage).
Fast forward a few months, a few different jobs and countless other patients later, Iâm guilty of forgetting about her. I receive the news from a colleague: remember her from the haem/onc ward? She didnât successfully find a stem cell match. She decided she didnât want any more chemo with months and months in hospital; sheâs chosen to go home and die.
Then everything I remembered about her came flooding back; though she may have been pushed to the back of my mind over the months, I didnât forget anything. And my heart sunk when I was told sheâd decided to stop treatment. Sheâd invited me, and the rest of the ward, to a ball to celebrate her life, with all the lives sheâd touched along the way.
I had seen patients die as a medical student. I warily anticipated having to do seemingly scary things as a doctor, like verifying deaths. But this was something that I didnât expect. When I worked with her, we were all hopeful sheâd find a donor, and that was still the situation when I left. It came as a shock to me that this is what had happened for this patient whom Iâd grown so fond of.
Iâm long removed from her care, so I could fortunately take my invite to go to the ball. I saw her in a wheelchair there. Iâd never seen her so weak, and it was heart-breaking. She gave an impassioned speech, where she told everybody that she wouldnât see her next birthday. It sent a chill down everyoneâs spines. But always seeing the silver lining, she declared that it was her birthday that night. I caught her later on, and she told me about her plans to now visit Australia, something she always wanted to do, but could never manage from the confines of the ward.
As enthusiastic as she was, I also remember the myriad bouts of depression she went through, and the frustration she was constantly battling. I saw it when sheâd tell me about her dreams of being at home, washing clothes. Things that we donât just take for granted, but consider tedious. Small things that would bring her a world of joy. She knew that each new infection meant at least another few weeks in hospital, waiting for her temperature and inflammatory markers to stabilise. There wasnât a day I saw her that she didnât pray to get better and leave the ward. She only stayed in the hope of the team finding a donor for a stem cell transplant, which was the light at the end of this long tunnel.
Itâs been a month or so since I found out, but Iâm happy for her now. I learned a considerable amount of medicine on that job, but more importantly, Iâve learned a lot from her (and all the other inspiring patients and their families on that haem/onc ward) about stoicism, resilience, the value of hope and the importance of dreaming. I may never meet anybody as strong as her in my life. Itâs weird to know that Iâve seen her for the last time, and that soon she will die. But as sad as it all is, Iâm glad all thatâs behind her now; Iâm glad that she can go to Australia as she always dreamed.