Sunday, 25 October 2015

Endings

I had passed my two AMKs, passed the SJT and passed the prescribing skills assessment.  I had been matched with my 6th choice on the FPAS list and had a job lined up waiting for me which would send me far from home to a DGH in The North  starting with a rotation in Emergency Medicine.  There was just one small hurdle to overcome.  I knew I couldn't do anything and what would be would be so I tried to keep busy for the three weeks of the holiday.leading up to results day  I spent a lot of time with Mum as I knew it was potentially the last summer holiday I would have at home, and I wanted her to really enjoy it as she would miss me if I was leaving.  We went shopping, we had crafty afternoons and we had lovely days together.  She wanted for nothing and I was determined she would have lots of happy memories from our last summer holiday together.  Mum was hopeful and she'd planned a celebration meal that family from all over the country were coming to.  It would be the first time she would meet Mr's parents.  She'd picked out a present of a new stethoscope she wanted to get me.  She had more faith in things working out than I did, after all, this is what I excel at.  I get so close, within touching distance and then fail at the final minute.

When the 2nd of July came around, the results would be released by an email at 12.  I was sick to my stomach with nerves and time went so slowly.  At 11:37 my phone binged:

RE: Outcome of Year 5 Progress and Award Board
         
Further to the meeting of the Year 5 Progress and Award Board, which was held on Monday 29th June 2015, we can confirm that the decision of the Board was as follows:

Award of BMBS

Kind regards

Registry Services

I did it..... I passed! After all the stress, getting a standard email like that was a bit of an anti-climax, but I wasn't fussy, it had the magical words in it.  I could not believe that the thing I had worked so hard for for so many years had actually, finally happened.  I was now a Junior Doctor.  I would be moving in three weeks to start my new job as the only F1 in Emergency Medicine in a hospital on the other side of the country.

Mum had done a good job of inadvertently distracting me on that day as she'd woken up with a bit of a chest infection and so I'd spent the morning looking after her.  She was feeling a bit drained so I got the GP out who gave her antibiotics and I tried my best to keep her drinking and eating.  Within 10 minutes of the email coming she'd started vomiting.  It was getting to the stage where she couldn't keep anything down and her blood sugars were rising so I eventually persuaded her to go into hospital.  She detested hospitals and doctors and was refusing but I told her if she didn't she's be too poorly for my meal and graduation the following week.  Dad and I left her comfortable and looking tons better on AMU getting fluids and antibiotics.  We promised her we'd be back in the morning to visit.

At 0415 I got a phonecall from the ward asking if we could go back in.  Dad and I set off chuckling that she was being awkward.  We expected to find her sat up in bed refusing treatment and demanding to see us.  I knew something was wrong when they took us into a quiet room instead of straight to her sideroom.  They all looked so worried.  The Med Reg came to tell us that she'd gone into respiratory and then cardiac arrest after coming back from her chest X-ray at 0400.  She had been proudly telling anyone she came into contact with that her daughter was now a Doctor and so they thought I might like to watch the resuscitation attempt.  I couldn't believe it, she was fine, so I had to see for myself.  There were so many people in her little sideroom there was barely room for Dad and I to get in.  She was in PEA.  They were up to the 6th round of adrenaline and were discussing why the transcutaneous pacing wasn't working.  Someone was being sent to fetch and ultrasound machine.  She had access both sides and IOs in her shins.  The CPR they were performing was so effective at perfusing her brain, she was moaning and trying to climb off the bed.  Every time they stopped for a rhythm check she lay lifeless on the bed again.  I had a brief moment of surreal panic as I couldn't see where I fit into the team and what job I needed to do to help.  There was already access, there was already fluids being squeezed in, what could I do to help?  One thing was clear, they were doing everything.

The consultant anaesthetist who was leading the arrest call lead Dad and I outside and talked us through what was happening.  He asked if we knew Mum's wishes and if they got an output back would she want to be put on a ventilator?  Was there any reason we wanted her on one?  At that point I dissolved.  Of course I wanted her on one.  In 14 days time she needed to be sat smiling in the audience watching me walk across a stage at graduation.  She needed to go wedding dress shopping with me when the time came.  She needed to meet her grandchildren.  She needed to celebrate me becoming a consultant.  What sort of a question was that to ask?  Dad and I looked at each other and we knew.  No.  She'd hate that.  She always said it was the worst thing having make the decision to turn off Grandad's ventilator.  We knew what she'd want.  The anaesthetist was told the ultrasound was negative, no fluid.  All the H's and T's were sorted.  There was nothing more to be done.  The people quietly filed out and Dad and I went in to sit with her as she peacefully passed away.  In the space of 24 hours I'd had the happiest news and the most devastating news of my life.  What was I supposed to do next?

Rest in peace Mum, sweet dreams.


3 comments:

anothermedicnohoper said...

Wow, I'm really sorry. I hope she made it, and whatever happened she's lucky to have someone like you there to make the decisions.

Kitty said...

I've been reading your blog since the beginning, and intermittently check back to see how everything has been going.

Firstly, I just want to say how sorry I am for the loss of your mum. I cannot imagine what you've been through, and I want to applaud you for being strong during her last few hours. Making that decision must have been so hard.

Secondary, congratulations that all your hard work has paid off. Thank you for updating us on your progress, and hope ED is going well. I'm sure your mum (and the rest of your family and friends) are incredibly proud.

Well done Dr Bean!!! :)

Half a doc said...

I used to follow your blog, I just read this, I'm so so sorry. I hope you are coping with grief and I hope that working like is going ok two years down the line.