The words we want to say are just as important as is our decision to speak, but sometimes through life's journey we speak better with no words at all.

Compassionate Care

The driver had looked away for a second and then her life became a blur of activity in the emergency room of the local hospital. She was a seventy-six year old woman who had been hit by a car as she crossed the main intersection of town.

After the initial assessment in emergency she had been quickly transferred to the ICU Department where she now, three days later, lay motionless. The mood in the room reflected

her condition, as the situation progressed from bad to worse. She had been slipping away little by little and the Dr. now felt that it was time to let her go. He had worked through the night but despite all efforts he couldn’t make her better. The collection of IV poles surrounding her were an ominous sign - she was on full life support and still he was losing. Her color had turned from sallow to a bluish hue as her oxygen levels fell while he fought to keep her blood pressure up, but he could not gain control.  He asked one of the nurses if they had heard from any family but the answer was a sombre ‘ no’ - she lived alone, had never married, had no children. There was no one to tell that she was not going to make it. As she slipped away, the medical team dismantled itself - there were many other critically ill patients to look after and the extra nurses returned to their original assignments. The machines were taken away and he was struck by how much more human his patient appeared when all the equipment had been removed. He stood by her bedside and instinctively held her hand. His thoughts turned to all his years of medical school and residency - none of which had prepared him for this. His grip on her hand tightened - he wanted her to know that he was there, that she was not alone. Her blood pressure continued to drop as each minute went by. Ten minutes passed. He wondered what she had looked like before the accident - what secrets she had to tell - what things she had liked to do - why she had never married. The monitor beeped - no blood pressure - no detectable oxygen levels and no electrical activity in her heart. This was the first time that he had experienced death in its entirety. He was alone in the room - the rest of the ICU was displaced from his thoughts. He was touched by her peacefulness and calmed by her stillness. 

It was now eight am and he had not slept for twenty-four hours - the rest of the hospital was just awakening. He was tired and confused as he did his rounds, saw the rest of the patients in the unit and completed his work for the day. His head hit the pillow at five pm - thirty-five hours after his last sleep. He woke up the next morning imagining her working in her garden - he knew nothing about her, but he thought it was something that she would have liked to do. It’s not often that people die alone in the ICU and he was glad that was not the case as well for his patient and he began to feel a great sense of accomplishment, despite having failed to save her life. Through this experience he realized that being a Doctor was about so much more than keeping people alive - it was also about helping people die in dignity. The twenty, silent minutes that he had spent holding his patient’s hand were the most important minutes that he had spent being a physician that day - twenty minutes that became a major, definitive step in his journey through life.