I am a Geriatrician

I am a geriatrician, looking after elderly people. Patients I look after them usually have lived 80-90 years. Many of them have multiple health conditions. At this age, most of them don’t have much time left and when they are admitted to hospital lets say with a bad infection, we know the outcome is not very good. One of the challenging issues that I often come across is how much to do more. Does the patient have advanced wishes in regards to their health and well being that we need to be aware of? Does the patient have capacity to consent and agree with our treatment? Is carrying active treatment when we know it is futile is in the best interest of the patient, especially in situations where family oppose stopping treatment.

There is not only legal aspects of these condition but quite often it can be mentally very disturbing for health care professionals.

I remember a lady with advanced cancer holding my hand and with nervous eyes asking me if she is going to die. The next day when I came I found she passed away that night. I remember her smile and her hope for life. I knew she had a terminal illness, but it was not easy for me to tell her I don’t have much to help what she hoped for.

I remember another patient who also had terminal cancer and then contracted COVID 19. This was in the peak of COVID. She was on maximum treatment, but unfortunately deteriorated. Our team did their best but we knew she will die. When I told her she doesn’t have much time, she smiled. That smile is still hunting me. It was a smile of hopelessness and not a smile of joy.

I cried after I left room of a patient. This was a rather young patient who was sadly dying of COVID. His wife was aware of the grave condition, but his teenager son did not know. They were both crying. Son asked me his dad will be well enough to play again football with him. I could not answer to that and when I came out, I went to my room and cried. I felt so bad as I felt I was useless.