She was transferred from hospital into hospice at the end of her life and only had days left to live. End-stage cancer had taken complete control of her body. We were handed over that it was important that we respect her wishes especially when it came to calling her by her proper name. It was a name that she had to fight for, that she had won for herself, but at great cost.
Not everyone understood her wishes. When her relatives came to see her they brought old family photos, and called her by a different name. She looked different in the photos, much younger, and dressed in different clothes. We were all young once. She was becoming less responsive as each day passed and her family talked about someone who sounded different to the patient that we had only a short time to get to know.
We talked about inserting an indwelling catheter to keep her dry, to try to protect her dignity and to lessen discomfort. She had adamantly refused when asked in hospital. Every time that we had to move her, it caused her pain, and we did not want to cause her additional pain. She had enough already in the many places that the cancer had invaded. We did our best to work within her stated preferences, what she had been able to convey before losing consciousness. We were concerned that we were approaching a cross-roads, where the need to provide comfort would outweigh the need to honour a patient’s wishes. When we faced these situations we would usually err on the side of comfort.
In the end her condition changed rapidly and the choices were taken out of our hands. Nature was reclaiming its child, and us mere humans could only try to make our patient more comfortable as she died. We treated her with respect, like the lady she wanted to be remembered as. Unfortunately even in the last hours of her life, her family could not do the same for her. They insisted on referring to her as him, and calling her by the boy’s name that had been written on her original birth certificate.
When we completed her death certificate we made sure that we wrote down her legally changed name and that her gender was recorded as female.
Rest in peace dear lady.