After waking up at precisely the same time that my community placement started today, I made my way to the headquarters of the organisation and met with the nurse that would be taking me on her house calls for the day. Because I arrived late (and without the evaluation form that I was supposed to take), she had already made the trip to the first patient, who – luckily – lives locally. He was a 20 year old quadruplegic who had suffered a C-spine injury while surfing 3 years ago.
I was glad I missed it.
John*, 93 year old diabetic. We arrived to his house in a surrounding suburb. The doors to his place were completely open, and we could hear him having a shower. The house was small but clean. While we waited, Ellen* – the nurse – told me John’s story. He had married three times, and his last wife was a Japanese woman who had discovered she had cancer several years ago. John, though much older, had cared for her until she decided to travel back to Japan so she could die with her family around. Now a widower, John has his son who comes to visit once a week. We checked John’s blood sugar level, which was good. Apparently, this was a surprise as the man controlled his disease poorly. Ecstatic at the news, John proclaimed his diabetes ‘cured’. Ellen and I tried to reason with him, but not even our yelling could be heard by the deaf man.
Elaine*, 73 years old, glioblastoma. We were greeted by Elaine’s best friend, who had come from interstate to care for her. She explained that Elaine had just finished the last of her 50 rounds of chemotherapy and radiation therapy yesterday. It was going to be a 6 week wait until the doctor knew if the radiation had been effective. Elaine’s cancer might have been eating up the cells that supported her neurons, but she was still sharp, and refused to move interstate to live with her friend, who had to leave because even though she loved Elaine - three months away from her husband and kids was too much. The women cried, and I could only sit there and try not to watch. Elaine was upset because her brother’s diamond anniversary was coming up, and she wasn’t going to make it. We talked about sudoku, the colour of yak’s milk (pink, which I knew thanks to a recent game of Trivial Pursuit), and why palliative care hadn’t organised a toilet seat for her.
Pauline*, 53 years old, lung cancer spread to brain. Pauline was rake thin, bald, and still smoked an unbelievable 130 cigarettes a day. We sat with her as she talked about her increasing nausea, and that she’d eaten only soup and pineapple the whole week. She was running out of pain medication, which wasn’t covering the pain anyway. Her parents had died of lung cancer, and her cousin. Pauline’s 29 year old son also smoked 100 cigarettes a day. She sat on a sagging couch that smelled of tobacco and told us that she was going to beat the cancer. Ellen smiled with her lips, but later, when we’d walked to the car, told Pauline’s sister that there wasn’t any hope for Pauline, and that it wouldn’t be long now.
David*, 58 years old, lung cancer spread to liver. We used a key to get into David’s house because he was on 24 hour oxygen and walking to the door was too much for him to handle. He lay in a hospital bed out in the garage, with the oxygen tank hissing. There was an Australian flag above his bed, a Victa lawn mower stored next to the oxygen, and three barbecues out in the backyard. David’s wife worked full-time, so he was left to fend for himself most days. because walking up the stairs to the shower was impossible, David had constructed a collapsable perspex shower so he could wash himself with an extension hose from the laundry sink. While he lay in bed, Ellen told him of a program where volunteers could stop by and spend a few hours with him so he could have someone to talk to and make him a cup of tea. He seemed like the kind of man to balk at suggestion like that, but after a brief pause he said that it would be nice. He didn’t look at us as he said it, and I wondered how much pride he’d had to sacrifice in order to just keep going.
It’s one thing to see palliative patients in the nursing home. They might have names, but they’re just another sick person in a bed. It’s different to see them within their four walls.
It was a really insightful day, and I’m glad I got to ride with the nurse who looked after my grandfather when he was dying.
* Names have been changed for all the usual reasons.
Doctor007.
