Posted by: medicblog999 | May 23, 2010

In that one moment….

IdeaLightBulb02Steve, over at the EMT Spot, will be hosting the latest edition of ‘The Handover’ blog carnival on Friday. The theme for this month is ‘and that’s when it all came together….’

Make sure that you go and check in on Friday to read everyone’s submissions!

He is looking for stories of moments when suddenly something just clicked and everything just falls into place. Maybe it is the moment that you realise that you can do this job that we expose ourselves to every shift; maybe it is the time when all of a sudden, that one bit of anatomy and physiology finally seemed to make sense or maybe it is the time when you actually made a difference and went home with a big smile on your face?

The fact of the matter is that I have had all of those moments at some point in my career to a greater or lesser degree, but I cannot say they have been the eureka moment that maybe Steve is looking for. I can’t really say a moment when it really all came together because I honestly believe that it happens too frequently but also not enough.

Does that sound confusing enough for you all??

The profession of prehospital care is so varied that you can have multiple episodes where something clicks into place, in one single shift, but to me, all that means is that I have learned another little bit that may help me be a better paramedic. These moments should never stop happening because if they do, then you are standing still and not developing.

Maybe I am taking this too literally? I know that he is looking for stories when a medic has the inspirational moment, usually when they realise that all of their training has finally made a difference and has led them down a diagnostic path that previously may have been a little out of their reach. Those times are to be cherished and remembered, but they are only stepping stones to greater challenges and more opportunities to learn and develop.

For my moment, I am going to go back 16 years, to a time when I was a student nurse and was working as a volunteer at a local hospice. I guess that my ‘moment’ was the time where I realised I could handle the emotional burden that comes with caring for people, and their families, who are at the end of their lives, whether that be expected or sudden.

For this, I will introduce you to a wonderful young lady called Samantha.

Samantha was a 23 year old woman, who had terminal glioma (a particularly nasty form of brain cancer) I seemed to bond with her very quickly and we rapidly became friends as well as patient and carer. I only used to do 2 nights a week, as I was studying full time for my final year in nursing, but I looked forward to seeing her and taking her out in the grounds in her chair for a little bit during my shift.

One night I turned up after having a few days off. Margaret, the nurse in charge came over to speak to me as I arrived. I was expecting to be told that Samantha had maybe taken a turn for the worse or had even died during my days off; however, luckily it was neither of those.

“Mark, will you spend some time with Samantha tonight? She hasn’t slept for the last two days and nights, and she is refusing to go to sleep”

I went in to see her and we started chatting. I didn’t want to bring it up as I just felt that if she wanted to talk to me about it, I was sure she would lead into it somehow. Sure enough after about 10 minutes, she told me that she was shattered, as she wasn’t able to sleep. I asked why, to which she replied

“I just know that if I go to sleep, I am going to die, and I don’t want to die yet, I’m not ready”

Before I realised what I was saying, instead of saying ‘don’t be daft’ or something like that which would usually have come out of my mouth, I instead said

“Ok, well what is it that you still need to do? Is there anything I can help with?”

After all, there was no point in pretending that she wasn’t going to die sooner rather than later, right?

We spent most of the night, sitting together and talking. She wrote some letters to her parents and her younger brother. We talked about what she had yet to do in life and what she was going to miss out on.

We discussed the bitterness she felt with her condition and how unfair it was that she was going to die before having children and a marriage. We had a few tears and even laughed at some points throughout the night, but as the dawn was beginning to break, she seemed a little more settled. She yawned a few times and looked like she was about to go to sleep.

“Come on Sam, have a little nap. I’ll stay with you if you want, and your Mam and Dad will be in at lunch time, so you can chat to them too”

“No, not yet Mark, maybe later though eh?”

By the time I was due to go home, I felt absolutely shattered. Exhausted to my core, but I felt as though I had helped in some way. Sam had a terminal tumour, but she wasn’t expected to die imminently. Hopefully, she would get some sleep today and when I came back in for that nights shift, she would be a little more rested and back to her normal self.

I went home feeling that I had really helped. I know how tough night times can be when things are stewing on your mind, but I cant possibly imagine what it must be like when you are coming to terms with your own mortality and impending death. Hopefully she would sleep; hopefully she would wake with a different outlook on her final few weeks. Hopefully….

Sam died at lunchtime then next day. Margaret said that she had her breakfast, and asked for a new pillow and her sheets to be changed. She had her curtains closed in her room and asked for a window to be opened to let some fresh air in. Then she went off to sleep……..

I felt terrible that night. Had I persuaded her to go to sleep? Had I someone brought about her earlier than expected death. She didn’t have her family with her….was that my fault too?

Sam’s death left me with so many questions which I have never been able to answer. I have my theories and maybe one day I will find out if I was right or not.

However, in that one moment, I knew that I had spent a few hours with someone who has left an imprint on my life. I knew from then on that I would be spending my life trying to care for people. Helping them get through tough times, possible saving some lives, maybe even just helping them die with dignity with a ‘good’ death; but always trying to do my best.

Healthcare was,  and still is for me. It is the only thing that I can ever imagine doing. I don’t know where my career will take me in the 25 years I have left, but I hope I never lose sight of the reason why I choose to do what I do; to make those connections with people and to share some of the most important points in their lives.

That is the gift that I cherish the most.

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Responses

  1. What a wonderful post Mark, you made my cry. Great to read about one of those moments in nursing when you know you've made a difference.

  2. A very inspiring post Mark. Thank you for sharing this.

  3. No, it absolutely was *not* your fault. What you did for Sam was a beautiful thing and you couldn't have done it more right.You gave her the chance to write those letters and talk about the things that were on her mind. Tears and laughter and the ability to express those are so very important. I'm in no doubt that she felt more relaxed, settled and peaceful than she had done for those previous two days with the torture of no sleep.The fact that she requested the new pillow and sheets, the closed curtains and open window mean that she was ready to accept her death and allow herself to slip first into sleep and then into eternity.Please try to let go of your guilt, if I'm reading it correctly that seems to be your feeling about this. Sam will be at peace, you helped to make it so that she was able to do as much as she could before slipping away. That's a gift.

  4. No, it absolutely was *not* your fault. What you did for Sam was a beautiful thing and you couldn't have done it more right.You gave her the chance to write those letters and talk about the things that were on her mind. Tears and laughter and the ability to express those are so very important. I'm in no doubt that she felt more relaxed, settled and peaceful than she had done for those previous two days with the torture of no sleep.The fact that she requested the new pillow and sheets, the closed curtains and open window mean that she was ready to accept her death and allow herself to slip first into sleep and then into eternity.Please try to let go of your guilt, if I'm reading it correctly that seems to be your feeling about this. Sam will be at peace, you helped to make it so that she was able to do as much as she could before slipping away. That's a gift.

  5. […] Mark Glencorse knows what it means to help someone die and he’s willing to tell you how, in that one moment, they can leave an indelibile imprint on your […]


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