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Who’d have thought it? No sooner are we all settling back into the routine after our summer holidays, than the shops are full of Christmas trees and it’s time to start thinking about buying presents.
Every year, when I ask Mrs London Eye what she would like as a gift, she comes out with same answer; ‘Oh, really darling, you don’t need to buy me anything’ – by which, of course, she means, ‘You not only need to choose something yourself, but it had better be decent!’
"I think the registrar and I may even have exchanged a quick celebratory ‘high five’ (when our boss wasn’t looking, of course)"
This predictable if endearing tendency to say exactly the opposite of what she wants, reminded me a little of an old boss of mine back when I was a Senior House Officer – although with him it was the other way round; he did the reverse of whatever you wanted. Many a time we would suggest that such-and-such a patient should have a particular intervention, only for him to decide on exactly the opposite course of action. At first this was rather annoying, but over a period my registrar and I learnt exactly how to play his game.
One weekend a lady with particularly severe vascular disease was admitted, almost moribund, her leg clearly threatening her survival. Presenting her on the Sunday evening round, I ventured the view that, ‘At all costs we ought to try and save this lady’s limb’. Sure enough, just as planned, I arrived on Monday to see her being wheeled to theatre for the above knee amputation she so clearly needed. I think the registrar and I may even have exchanged a quick celebratory ‘high five’ (when our boss wasn’t looking, of course).
Whatever may irk us on our various surgical firms, at least we can rely on the fact that, for the most part, our patients actually want our treatments for them to be effective. Not all patients share that outlook. A recent ITU patient had tried to end their life by setting fire to themselves whilst suffering from a psychotic illness. After prolonged and painstaking critical care, they recovered enough to confirm that their fundamental wish to die was unchanged. Their vocal expression of this view distressed staff, other patients and those patients’ relatives.
This was a difficult situation for ITU staff who needed to balance the risks and suffering associated with their care, the patient’s wishes not be treated and their disordered state of mind; an ethical decision if ever there was one. I couldn’t help feeling for my colleagues who had worked so hard and found myself feeling thankful for the gratitude, and indeed the will to live, of the people I am normally involved in trying to save. Oh well I suppose I’d better go and press on with the Christmas shopping; and in fact, on that note, from down here in the Big Smoke, a very Merry Christmas to you all.
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