A counselling psychologist's experience(My patient has died Part 9)

I had just begun my attachment at the hospital and super eager to do a good job.

“Work hard so they take notice of you and hire you” said ALL my relatives.

I was one of the not so lucky ones that got thrown into the deep end, the critical care unit. There didn’t seem to be anyone to counsel or offer the kind of services I was trained to provide. Just loud machines I did not understand how to read. (No, all the medical series didn’t help. At all)

It wasn’t long before we were hurdled into a room for what we thought would be orientation. Three strange men followed, the last one was broken, bereaved. I could tell because death gives everyone the same sombre look.

Our supervisor informed them that their brother has died, she answered all their questions, and made them feel that even though it wasn’t going to be easy, we did, really, do our best.

With time I’d learned the ropes. In a couple of weeks, I was doing the same, explaining the prognosis and breaking news. It was never easy.

I’d always pass by bed 21 afterwards; the patient who almost died but didn’t. He was the only conscious patient I had at that unit. He was said to be depressed and stubborn. Though at some point, we were more of friends than patient and therapist. He knew how to live, laugh and love even when surrounded by death. He knew how the bodies were wrapped;
he’d lost count of the new neighbours he’d seen being wheeled to the mortuary over the years.

Even so, 21 was hopeful. He was going to recover and be home in time to watch the world cup.

Being around for so long afforded me the opportunity to meet his family, sadly, his kid brother was never allowed to visit (hospital rules). But they’d made plans to make up for the
birthdays he had missed.

21 would suggest series for me to watch and ask for strange sandwiches, or just the eclair he’d occasionally crave. I couldn’t bring him any (again, hospital rules), but the series were good.

One day when my colleagues and I were making our rounds we met his grandmother in the
corridors and she was excited!

“My grandson’s birthday is on Saturday, we’d love for you to come and celebrate with us! “

I didn’t go, I hear it was amazing. The cake was large! ( I made a
point to bring him his sandwich to make it up to him though.) 21 was happy as he’d been informed that he’d be going home in a couple of weeks!!

They assigned me to a new unit. I had new patients, many critical… but I knew I needed to make time to visit 21. I didn’t. He was to go home soon anyway so my job was done. He was no longer depressed. Heck, he was excited and always laughing. My colleagues said he was doing great!

He had a minor surgery scheduled for that night to have his bed sore patched. Simplest of surgeries! He’d had such invasive ones before, this was nothing.

Days passed and I forgot. We forgot. We had new patients, and news to break to families. Some of us had new ropes to learn. (New departments and what not.) Occasionally we’d talk about 21 and how we’d forgotten him. But he would understand, he
always did when we disappeared.

It was the Monday after what felt like a long weekend when we bumped into our supervisor from 21’s unit. She didn’t say hi, she waved though…Which I thought was fine.

“She’s busy, we’re busy. Let’s visit 21 today” we decided.

21 wasn’t there.

“Oh, he was supposed to go home! We’ll just call him. “

21 didn’t pick up.

Then our supervisor called and had us meet her.

“21 died in surgery.”

Why do I call him 21? Because that was his bed number. Also, I unlearned his name. I’m sure I could find his name in my phone book if I looked hard enough, but I don’t want to.

My work was not done. When 21 died we had to break the news. We had to explain to his younger brother why they couldn’t have the birthday parties they had planned. We had to explain to his family what happened, to debrief them and have them receive the news in the best way
possible. I’m not sure that is possible any more, but that’s what they teach you to do.

21 taught me, my patients are not my friends. I viewed his body. I hoped he’d wake up. I did not want to answer his grandmother’s questions. I wasn’t his doctor. I don’t know his doctor. I did my part. I helped him cope, adapt, conquer. All of that still meant nothing once they’d put
him under. Sheer willpower, high levels of self-awareness and self-worth are useless when
you’re not conscious.

Do I regret having had 21 as my patient? No.

Would I take up another critical patient? Yes, I just won’t take their phone number.

There are other 21s now. Some die, some go home.

I went home that evening and when asked how my day was, all I said was, “my patient has died.”

Mueni’s comments: Our second last post in this series and what a story! Thank you Maria for sharing this with us.

What are your thoughts on befriending patients? Is it a slippery slope for medics or does it strengthen the doctor – patient relationship ? (whether you’re a medic or not, I think we can pick your brain on this. )