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Why didn't we recognise the warning signs? I wish I had an answer for my dead patient's husband

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21.05.2019

I am inside intensive care, looking surreptitiously through a glass window and preparing myself. I see a patient crowded by tubes, machines and stricken relatives. The figures in front of me tell an unmistakable tale of disaster. Everyone knows the patient is dying; apparently, they’ve been waiting for oncology to give the word to pull out.

“It’s not good”, the intensive care physician says. “We’re thinking she’s had enough. But we waited for you as it’s a chemotherapy-induced complication – the family needs to hear you say it’s time.”

The patient is a working woman with a husband and children. I burn under the gaze of many eyes trained on me, asking what someone will eventually blurt out privately: “How can you give chemo to dying people?”

I tread softly inside. The patient is drifting into unconsciousness. She denies pain and I’m glad.

Her family ask if it’s true she is dying. Feeling ruthless, I say yes. Adding that even if she survives, there is little hope of recovery. I ask them about their expectations. They tell me that she never really felt well after diagnosis. Nonetheless, last week they were having dinner together, knowing that her prognosis wasn’t good but not so grave either.

“I am very sorry that she became so sick with treatment. Our intention was to make her better.”

They look at me with bleary eyes, too spent to challenge my bleak assertion. Finally, her husband says: “Our heads are spinning, but we have to let her go.” The four daughters agree.

The family flocks in. Goodbyes are murmured. The machines are silenced. She dies. Like everyone else, I am inexplicably moved by the family’s grace, pragmatism and acceptance. Not every family lets go like this.

The family says everyone tried but at such times, doctors can be seized by an indescribable urge to make things better.

“I can’t change the past”, I say, “but I promise to look into what we could have done better.”

They have no........

© The Guardian