Death (My patient has died Part 3)

Before the last decade, I had probably gone for one funeral, known only one person who was family who’d passed on…

Death was a very foreign concept to me (but somehow, greenhouses gave me the creeps when I was 7 because I somehow associated them with death).

I had never for one time had to sit down and go through the motions of sickness, death and grief. Maybe it was the naivety of being a child. Naïve is too strong a word. It was the innocence that came with being a child.

Fast forward to October 2016, I was staring at an empty bed, a bed which for a couple of weeks had been occupied by a sweet lady who happened to be the first patient that I ever clerked.

I didn’t want to ask the question of which I knew the answer to. I was simply a third year medical student, fresh from her pre-clinical years, what did I know of death, especially death in the workplace?

This woman had become part of my routine. Get on the lift by 8:45am, reach the ward, go greet her and find out how she slept then go join my colleagues waiting for the ward-round or teaching to begin.

She had a terminal illness and all she needed was a couple of Kenya shillings to get a procedure done that would increase her quality of life and the time that she had left on this earth. (A side note, get insurance. We can wait all we want for Universal Health Care all we like but for as long as politics is involved in issues dealing with the health of a people, you’re practically on your own).

Every day she seemed to get worse and worse and looked more cachectic than ever. She also saw where she was headed towards, so on that morning when I came and didn’t find her and found that empty bed, I knew what had happened.

I didn’t want to go and look at her file or ask the nurse. I kept it inside, pushed it, shoved it at the back of my mind, learning how to compartmentalise.

Isn’t that what we needed to learn to do?

How else would I learn to separate my emotions from school or work?

As the days went by, you could hear a family crying, screaming, wailing after being broken to the news. This was a daily occurrence, every day, we’d see death.

Once it was in casualty when a child who was simply eating porridge was being resuscitated for 20 minutes without any success. It started to get to me, slowly but surely.

Back home, we’d just buried a relative and other family members were getting sick. I eventually reached my breaking point. I questioned everything I knew.

Did I want to be in this? Be a part of this? I don’t think so.

I hit a slump but thankfully, the months that followed, our university went on strike and it afforded me a chance to take a break from all of it. I took a step back and I started dissecting my emotions, the ones I’d decided to shut off.

I needed to do that, I realized. It helped me unpack a lot of what I’d decided not to deal with. It helped me move on. It made me look at things maybe a bit differently.

On some days, I’d sit with my grandmother and she’d help me see past the sickness and death. She’d give me a different perspective that was filled with less science and with more realism.

It’s roughly 3 years later and I’ve seen more deaths than I imagined I would have and I am still ambivalent about it.

On one hand, I keep telling my friends that death is a surety for as long as you’re breathing. It’s something that each and every one of us will have to deal with, either professionally or personally. Such are the complexities of this life.

On the other hand, it isn’t normal the sheer amount of deaths we see as health professionals and there’s learning and relearning that needs to be done concerning how we’d need to not only deal with it but also help loved ones of patients deal with it.

I read an article the other day written by an emergency medicine physician from the States who begged the question of how as a doctor, as the one who’ll be the bearer of bad news, how you’d want a family to remember you besides you having to deal with it.

My only hope is that I will not lose my humanity through it all.

Peace! Rachel Ngonyoku.

(Thanking Rachel deeply for honestly expressing a silent fear among medics. “My only hope is that I will not lose my humanity through it all.”)

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