Palace of Care – Existential Devastation

Photo by Pacific Office Interiors on Unsplash

I was worried about my patient. Swallowing was compromised. Their thinking was compromised. Oral intake was minimal. More of the day was taken over by the need to sleep. Pain control was still inadequate. They felt so out of sorts, miserable in all aspects of their being. A proud person who had worked hard to overcome many difficulties. Trying harder had worked throughout life. The same attitude prevailed during the cancer battle. Pushing themselves harder and harder, no matter how terrible the side effects or the pain. Sheer determination and willpower saw them through.

This came at the cost of themself. They hadn’t felt normal for a long time. The physical pain could be tolerated but the inner voice of existential distress had become unbearable in recent weeks. It could not be ignored. Nothing felt right. It was not supposed to be like this. They should have been planning for a family holiday rather than their own funeral to ease the burden on the family. A casket had been chosen and of course, it had to be in the favourite colour. Different from most people’s preferences but being different was nothing new. Growing up as an immigrant in a mostly white country you are used to being different.

There was so much that had been planned for the future, the future stolen away by cancer. Cancer took away too much and had not finished. It was taking precious life away, draining the internal battery constantly. The image in the mirror was shrinking day by day. The sense of intactness was long gone. Feeling like themself, was but a distant memory from a bygone era, from someone else’s life. There was still too much to do. The need to get everything just right had always been there, now it was all-consuming. Too many competing priorities and time, precious time, was running out. Too many thoughts smashing against each other in their head. Unable to make sense of it all. The nights were the worst time of all. The long lonely nights were when the thoughts reached their crescendo and then deteriorated into cacophony.

Out of desperation the idea of assisted dying kept on returning. The suffering could not be borne any longer. What was the point of living longer in order to suffer more? It was against the long-followed religion’s rules. It was not what the family wanted, but it was too much to handle. “Enough, enough, I’ve had enough. I can’t take it any longer.” The repeated prayers remained unanswered. “I’m ready for heaven, please take me, Lord, I will miss my family dearly, but I need to come home.”

The doctor said he could calm things down but it would involve using medications that had been resisted for many months. The doctor said he would make them comfortable, and allow them to relax.

He said, “If you become unable to speak for yourself our team will continue to act in your best interests. We will keep you comfortable. We will protect your dignity. We will get you through this. We will also look out for your spouse, your children, and your family. Do you trust me?”

“I do trust you.”

“Okay, I’m going to change the medications and hopefully things will calm down.”

Nothing happened in the first two hours, it felt just the same. The tsunami of tears could not be stopped. “It’s not working, is this what I am stuck with?” After the third hour, the arguing voices inside their head stopped shouting and spoke to each other politely. “I can think again. It’s like noise-cancelling headphones. I know what I have to do.” This was followed by the best sleep in months.

The next morning everything felt different but at the same time, so familiar.

“Doctor, I feel like myself again.”

“What have you got planned today?”

“What have you got planned today?”

“I’m going shopping. I’d been thinking of buying a piece of furniture for the living room for the past few years. I kept on putting it off. I’m going to buy it today, before my time runs out. It will be in my favourite colour. See what I’m wearing today.”

“That’s my favourite colour too. Check out my socks.”

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