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.

 An here I come after many years.

Many years passed since last I posted anything. Lots of things changed. I will post what I have recorded.

And here I had my surgery:

IT was around 830 AM the nurse came and informed me that they are going to shift me to operation theatre. Though I was ready for it, but it was shocking. I am going under general anaesthesia, they are going to drill my skull, remove the bones and remove the cholestheatoma. Any how, I had to do it. So I changed, wore the surgical gown. They placed my on the stretcher and toke me to OT. In the OT I were received by nurses, and doctors. Many people around me, one confirming my identity, other checking vital signs, other checking IV site. I felt my IV site is hot, and then then I didn’t remember, went to deep sleep.I woke up from dreams, and I felt i had along sleep. I was feeling nauseated and I vomited two time. I can remember the nurse helping me to turn my head to one side while throwing up. I felt too much dizzy. And then…? Did I had my operation? Yes…I had dressing on my head. And I asked did I got my operation? They said yes, I asked the time, it was 4 PM. Oh my GOD I had almost 6-7 hours surgery? How happy I was at that time, because I did not feel the pain of incisions and drilling. Suddenly the possible complications of surgery came to my mind; do I have facial palsy? How is my taste? How is my hearing? So I started moving both sides of my face, and I could do it. I moved my tongue and tried to see if there is any numbness, and it was ok and finally I scratched the dressing in my left ear and I could hear. Alhamdulillah, I can not express how I felt happy. But I was just out of anaesthesia, I was too much dizzy, I could barely move of hands and legs. And it was at this time that my wife came to my mind. She was supposed to come to hospital with the kids. Where is she? How is she doing? So I asked for my phone. The nurses tried to comfort me, but I insisted I wanted to talk to my wife. And finally I got my mobile, called her. I was telling her I had just a dressing of my ear and I am ok, but she already knew, and told me they are waiting in my room with my brother….continued.

And I can feel this Hadith by every cell of my body:

"There are two blessings which many people waste: health and free time.”

Alhamdulillah

And Her it comes, time for surgery:

Tomorrow I will go under surgery for my left ear cholestiatoma. This afternoon the Anaesthesia consultant came to take consent. She described the possible complications anaesthesia, that includes hypotension, hypertension, sore throat after intubation. What is my choice? nothing, just to accept it. I need the surgery. And in the evening the ENT consultant had along discussion. He described the procedure in details, what he expects and what he doesn’t expects. The operation may take 3-4 hours but it could take more then 5-6 hours. He described of possible complications; facial nerve palsy, loss of taste, loss of hearing, possible recurrence and many others. He was telling he will do his best but I need to understand the risks and to decide. I have to trust in Allah SWT to save me from those nasty complications.  It has been almost 2 months I am suffering, taking IV medication for 1.5 month and sleeping in the hospital for around 10 days. I feel nervous, anxious, but have no other choice. But I am happy I am getting premedication. 

When I will close my eyes the doctor and his team will start by drill, and I hope by the time I will open my eyes I will be in my room. But who know……?