Tag Archives: conversation

Palace of Care – What do you think is going on?

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Photo by Joanna Kosinska on Unsplash

The hospital doctors said I was very unwell, and that they didn’t have any treatments left for me. They said I might not have much time left.

Did they say how much time you had left?

Two months, maybe a year.

What do you think?

Nah.

You think you have more time?

Yeah. I’m trying the other medicine from the islands. I’ll see if it helps.

Which one is that, the white stuff?

No, the other bottle.

Oh that one. $40 a bottle. How long have you been taking it?

About a month.

What’s it taste like?

Sour. Yuck very sour.

Not as good as the Ribena?

No, I take Ribena afterwards to get rid of the taste of the medicine.

What is it? Is it from your island?

I don’t know, it’s from my partner’s island.

How long have you been together?

18 years.

Where did you meet?

Over here.

How’s your pain?

Okay.

How would you score it out of ten? Zero being no pain, ten being the worst you’ve ever felt.

It’s not bad just a 7. When it is real bad it can go up to 10.

Does the pain medicine help?

Yeah, I think so.

How low does it bring the pain down?

To about 5 or 6.

Does it ever go down further?

No.

How about when you were in hospital, they tried some different medications for you. Did they help?

Nah, it didn’t make any difference.

Okay, we’ll need to try something different as your muscles are twitching.

Why is that?

It’s a side effect and it’s telling us you have come up to your maximum dose with that medication. We need to switch it to something else. I’m hoping it will help your pain more with less twitching.

Palace of Care – Straight Up Now Tell Me

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Photo by Larm Rmah on Unsplash

Things hadn’t been going so well in recent weeks. Our patient had needed to come in for treatment which helped one of their issues, but came at a great cost. Pain was made much worse for most of the day after the treatment was given. This was on top of a high background level of pain already. I suspected our patient downplayed their pain. They were well versed in putting up with significant amounts of pain. There was no questioning their toughness and strong determination.

I said to them, “anyone else would not have been able to handle what you had in the past year. Most people would’ve stopped treatments after the first two cycles, but you had more than ten cycles. I think you have stayed alive through sheer will power alone.”

We had come to the point where, “First Do No Harm,” had to be considered. The treatment we had provided had made the symptoms worse, it had increased the suffering experienced. The entire management plan needed to be reassessed, with the patient and their spouse. A meeting was scheduled for the next day.

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