This does not have a happy ending

 

A 90 something year old feisty lady was admitted to the gen med ward overnight. The year was 2017. Influenza was particularly rampant and hit the most vulnerable. Many deaths resulted.

Anna, my consultant, our two excellent interns and myself were informed at morning handover that this lady was “very unsettled, calling out and hypoxic - requiring high flow oxygen”. Walking into her room we found a well-groomed lady calling out “Arthur!! Arthur!!! I need to see Arthur!!!!!!”.

Anna greeted this lady, asked her what was wrong and who Arthur was. It was presumed she was delirious prior to that. This lady told Anna that Arthur, her husband, has dementia and was all alone in the facility they lived at. Arthur gets nervous without her and he needed to see her. I got a phone and got through to Arthur and Mrs X calmed down after chatting to him.

It was clear, however, that Mrs X was very ill and may not survive the event with days to live. We told her - and she was ready for death but her one and only wish was to see Arthur again. We therefore organised for the facility to take her back. Transport and palliative medication (when needed) had been organised.

The next morning, Mrs X was still at Footscray hospital. We found out that the transport crew arrived after 5PM and had declined transporting her due to her oxygen requirement indicating that she may die en route. This was their policy.

When we saw her that morning, she was drowsier than before but still able to have a conversation about wanting to see Arthur.  We called the facility and organised for a staff member to bring Arthur in after much to and fro discussions and pleading with them - to fulfill a dying woman’s wishes. They agreed to bring him in later in the day, afterhours. My intern also organised for Mrs X to see Arthur via Facetime.

 

Unfortunately, Mrs X passed away a few hours later, prior to Arthur coming in.

 

My one comment is that as doctors, we have the privilege and unique opportunity to provide patients with a good quality of dying and this should be one of our tenets of medicine.

 

Dr. Melissa Tang

 Names have been changed to ensure the privacy of those involved in this true account is protected.