‘Scans had revealed a tumour in his lungs, which – thankfully – was operable. A decent operation, and he would be as right as rain. But after the surgeon removed a chunk of his left lung, for some reason we couldn’t stop his bleeding. Over the next few days, we were faced with a strange conundrum: here was a man in his early forties, who’d always been in the best of health, but was now uncontrollably coughing up blood that simply refused to clot.
We asked specialists from around the country to examine his case and eventually learned that he was generating antibodies against his own platelets – his own body had turned against him. The tumour had produced substances that had confounded his immune system and triggered an attack. The condition was rare and life-threatening. We gave him a high dose of medication against the antibodies, but it had no effect. Every day we put him on a fresh IV of blood platelets, a lifeline that was supposed to help his blood to clot. But nothing worked. He had spontaneous bleeds, bruises everywhere and was constantly coughing up blood. The drain coming out of his lungs was a deep shade of red.
I was the ward doctor, had just started out, and I saw him every day on my rounds. His wife sat at his bedside, along with his four-year-old daughter, who was happily playing the whole time. He had pinned all his hopes on me and became more desperate with each passing day. He’d clutch my hand, begging me over and over: Please, let me survive, you have to save me, my child deserves a father to see her grow up.
His condition had only been reported a couple of times in the international journals, and once we’d consulted all the available professors – even tried experimental drugs – there was nothing more we could do. That was when it hit me: he’s not going to make it. I sat beside him and heard his pleas but could only tell him that the end was inevitable. I was totally honest with him, but man, it was hard.
I do try to keep an emotional distance from my patients – once I’m at home, they’re off my mind – but I couldn’t let this man go. He was living proof that a death sentence can befall any one of us, from one moment to the next. The fact that he was so young made his case all the more frightening. His sadness and desperation are as vivid to me now as they were eleven years ago, and I can still picture his daughter clambering up onto the bed for a cuddle. How do you tell a child their father is going to die? Where do you find the words, when there is nothing more you can do?
He ultimately accepted his approaching death. He had no choice. Every day I dreaded going to see him – what was I supposed to say? Yet I knew I had to sit there beside him and keep listening, until the final day came. That’s the lesson I learned from him, one which has served me well ever since: our profession isn’t all just medical and technical, it’s also about giving time and sincere attention.
I was with him when he died. He was about to bleed to death, and to prevent him being conscious when it happened, we gave him a sedative to send him off to sleep. After he died, all the doctors and nurses came together to discuss what had happened. We were in shock, and it helped to share our thoughts with one another.
What do you do when you’re all out of answers? That’s what this patient taught me: be honest, listen and, above all else, never walk away.’