Covid 19 the gift that keeps on giving. Why does it have to be so generous? It has affected everyone and everything in the world, and the hospice is no different. We have had to impose visiting restrictions on our patients and their families in order to limit spread of the virus. Covid restrictions and quarantine requirements have led to some of the most upsetting situations that I have witnessed during my career.
When someone is dying, it is natural to want to be with them, to support them in their moment of need. They were there for you when you needed them the most, and you want to reciprocate if you can. Even before Covid it could be difficult to travel back home thousands of miles, trying your best to make it before your loved one dies. During Covid it has been that much worse.
My patient came in because of severe pain, a common reason for admission for many of my patients. His wife accompanied him, and they both looked exhausted. His pain had been poorly controlled over the weekend, and the nights had been especially long. The medications did not seem to work for long, they gave him a brief period of respite before the pain would come right back. It was almost cruel to be granted that small packet of relief, and then it would be roughly dragged out of his grasp again. This cycle repeated itself over what felt like a long two days. By Monday they needed help and he was admitted into hospice.
A day and a half later and his pain was better controlled, but then he started having trouble moving his left leg. It wasn’t painful, it just didn’t seem to be under his full control any more, at times it felt like someone else’s leg. At times it felt squishy and as soft as an octopus tentacle, that was at his weakest. It just would not work, was this cancer related, or a stroke-like event. My money was on the cancer.
His son was on the way back home from the United Kingdom, a long flight, but he really wanted to see his dad, in person. The video calls were better than phone calls, but the clever Asian companies have yet to invent a way in which hugs could be transmitted over the inter-webs. He also wanted to support his mother, through one of the toughest times in her life. Thus the son left his babies and wife in the UK and started his trip home. We heard that he had landed and went straight into Managed Isolation and Quarantine (MIQ.) He would have to stay there for the full two week period and would be subjected to a number of tests, before he would be let out. He was back in the same city as his father, and was staying only 20km away.
The son had to wait in MIQ, and wanted to see his Dad as soon as possible. His mother could also have used his support. I wrote a letter to try and sway the powers that be that were in charge. Unfortunately my patient’s condition would not wait, it continued to worsen, to the point that he could not read his usual morning paper. His daily reading streak that he had maintained for the past 40 years, was broken. That’s how he felt overall, broken in many ways. He really wanted to see his son again and tried his best to hold on for just a while longer.
We updated our support letters with what we assessed to be our patient’s shortened life-span. The son was a man of means and hired a lawyer who had successfully sued the government in order to have another client released from MIQ early. The lawyer felt comfortable that he would be able to obtain an earlier release for the son. This was all being set up for Thursday 11th. Fingers crossed.
Major changes had started hitting our patient on the 9th. He became sleepier, and found swallowing harder to do. He needed to be nursed in bed, as his legs had become weak and unable to support his tall frame. These changes were conveyed to his son, and increased his stress levels even more. The lawyer was confident that he could get him out to see his Dad, the high court session would be on the 11th.
The night of the 10th was the last time my patient talked to anyone, he became unconscious, and we kept him comfortable. 30 minutes before the high court session was due to start, my patient took his last breath. So close but yet…
The news was conveyed to his distraught son whose despair was worsened by still being stuck isolated in MIQ. Hospice counsellors conducted virtual sessions with him online, but they were not as effective as face to face sessions, and no words could take away his heart-break. Only time would do that, and he still had to wait out his sentence in MIQ before he could even help with funeral arrangements.
Author’s note: A horrible situation, and unfortunately one of many I have witnessed in the almost two years following this case. In recent weeks another son came back to NZ to try to visit his dying father. He was not let out of MIQ until after he had been on his hunger strike.