Nov 16, 2018

The Thinly-veiled Curtains

I can't remember the last time I felt subdued coming back from work. If I'm to guess, the last time I encountered something that made me feel raw from the end of my hair to my very toes was when I came upon the undiluted rage as a grief coming from the relatives of the deceased patient. Sure, death comes and it goes. I saw more deaths since then. But over time they no longer shake me. I do fear of my own death but its crippling fear and sadness that blacken the grief just seem to mellow down.

In other words, death becomes impersonal to me. It simply became one of the simple yet unchanged outcomes of the patients coming in to the hospital. It does not change when I came to the ED. There's just so many things that need to be done, so many patients to look after, that Death bustles in and out in between the multidirectional torrents of people here like the easy flow of air. 

When you are too busy at work, deaths become harder to affect you. Sometimes it feels like there is a layer of veil that cover your eyes from the presence of the demise. That's what it always feel to me. I skirted here and there, fast on my feet maneuvering along the lengths of this thick curtain just to avoid getting tripped in the seams of Death. Anything but to deal with the grief that comes after the Death leaves. I make do with the necessary paperwork and occasionally I provide some explanations to the family, but never to witness the aftermath that follows. Deaths are impersonal, I reminded myself.

But it is never a simple, fail-safe neat trick. In came a man in his early 30s brought by the stretcher with an MA on it performing CPR to him. He was playing football when he suddenly collapsed on the field. We were already informed regarding the case beforehand and had already prepared one resuscitation bay area for him. Once he was safely transferred to the bed, the green curtains that cover each of the eight bays of the red zone, were drawn over Resus Bay 4. A number of things were done simultaneously - probes and cuffs were attached, lines were inserted, mask delivering oxygen was put on, and a small line of people queuing up for their turn to continue the CPR. Sheets of papers were filled up, passing of important figures and instructions were heard - all within the confinement of the drawn curtains separating between the attending staff and the onlookers.

However, there's simply no amount of curtains that can cover the anguish cries of his family members who waited patiently just outside the curtains. In between the thumping sound of the recoiling chest and the verseful of commands, all sounds and noises waved into frequency. Even during the hecticness of the situation, I could make out exactly everything that was happening. Of the soft voice of my MO explaining to the widow that there's nothing left that we could do, the beeps of the monitor yelling the level of Oxygen in the blood is fast diminishing, and the sobs of the deceased's friends who just arrived to the ED having learnt of the devastating news. It was getting all too familiar and all too painful. After everything is settled, I skirted again in between curtains in the red zone with only one or two glances towards the ones who are left behind. Again I said to myself, Death is ever impersonal.

Later at some time near midnight came in another patient, this time a middle-aged lady brought via a stretcher again being CPR by an MA from the triage. We quickly got into the usual routine and, "skreeet!", the curtains being pulled over. This time I handled with the things outside the curtains, namely getting the history of what's going on with her. The one standing outside was the patient's sister and after a brief of the history taking, I asked to talk to her son to tell me more about her condition as he was with her when it happened. In walked a teenager - lanky, medium build with dark brown complexion.

He gave off the impression of someone coming from a lower socioeconomic background, an impressionless kid coming from the suburban and rural areas - something that is actually expected. No 17-year old who spends time with school and friends should be knowledgeable about medicine and diseases, but it was a disadvantage all the same when taking a history from people apart from the patient themselves. Some patients don't even know or care about what's wrong with themselves, let alone of other people knowing about the health issues of the patient.

He said that his mother had been having breathlessness for quite some time now, and when he came back from exam that day (Day 1 of SPM), his mother told him that she had a fall. She didn't feel so good so she asked him to buy him dinner and so he obliged. She went to sleep early and sometime at 8pm she woke up and asked for water. The son later slept beside her and was startled when he noticed her mother's snore suddenly stopped. He tried to wake his mother up but she didn't wake up.

All the while when he was telling me of what's happening at home, I couldn't gauge his reactions at all. He was stoic. Unlike her aunt who was visibly distraught and near tears, he kept to himself and just stood at the corner beside the resuscitation bay silently. I couldn't see where his gaze was at and it was a bit unnerving. After more than half an hour of resuscitation attempt, she also succumbed to death. My MO then came out and stood in front of them, explaining that unfortunately the patient had passed away.

The aunt broke into tears and sobbed while hugging the nephew's head. Again, he was silent, but the gaze was no longer there. It just.. went away. He didn't cry, he didn't shout in anger, he was just neither here nor there. I did wondered, later that morning, whether he already expected the worst and was bracing for it to be confirmed. Imagine his love and his world gone forever but there she was, only inches from him. Imagine him going back home with one less person in it. The rest of the red zone was still the disarray and I was needed elsewhere, so after I was done I began to walk away from them.

And that's when I saw it - the curtains was pulled back a bit, not much, more like from the billowing of some unknown wind that lifted part of the curtain - of the boy, still silent, bending forward over his mother's head and kissed her forehead in the most serene and heartbreaking way of a son saying farewell to his mother. There's no tears coming out from him, only the act of love that will never be responded.

I was reminded that not all love are shown. Or need to be displayed. That we never know a person truly, only of what they choose to show. There are many layers of veil covering what's inside of us and what is outrightly display to others. When I looked at the deceased ID card taped onto the clerking sheet, I saw that of her round, smooth face covered with a scarf. It was a different person from the one I was doing crash intubation to.

It strikes me that for every patient that come to us, they are someone else's mother, father, spouse, child and etc. That in everyday's work, it's easy to forget that there are veils that cover who patients are and their mark into the world. That every patients have more than just a face and a name. Each and every one of them deserve as much respect and dignity when we are treating them. That at some way, we allow ourselves a few moments of time in silence just to think of them. And for that, I dedicated this piece of writing to remember them by, with prayers in-between, and a promise of work efforts that they all deserve.

1 comment:

  1. Nice post to share. It teach me something for sure.