Article 13283 | Grave Matters
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Stop fixing me, why do you keep fixing me?

One of my most memorable encounters with an elderly patient, happened in my first 6 months as a newly employed professional, in the area of cardiology within the health care sector. This encounter helped me to open my mind.

I have seen a lot of elderly female patients (75 years and older) who are admitted to hospital and treated for myocardial infarction. I don’t know why I am always surprised to see these female patients, maybe it’s because on TV patients have typically been portrayed as a middle-aged overweight male clutching his chest as he falls to the floor in agony. Although the reality is quite the opposite, because some of these elderly patients are quite frail and have extensive co-morbidites, it is often decided that it would be in their best interest to treat them medically rather than for them to have an angio +/- PCI.

One day at work during my Hospital Ward round, I met a tiny-framed elderly lady sat in the bed in the far corner of the Ward bay. She was a medically managed NSTEMI patient who had recently self-discharged having refused to have an angio +/- PCI during her last admission. As some of these elderly patients are quite frail and have extensive co-morbidites, it is often decided by the doctors that it would be in their best interest to treat such patients medically rather than for them to have an angio +/- PCI.  She was approximately within the 90 years of age range, who had such a wonderful sense of humour. Once my registrar wanted to clarify her age and she replied “I’m only around 90 years young” in her usual playful manner. She reminded me of the national treasure Sir Bruce Forsyth with her comedic timing and delivery. As always when treating patients, it is important to centre their care around their wishes providing they have the mental capacity. She firmly informed the team that she wanted to go home and refused any other treatment. “Stop fixing me, why do you keep fixing me?” she said in a jokingly manner, however it should remembered that many important things are often said in a joking manner.

It was nearing the end of my shift and I was eager to get home, as I was all set to go on a trip abroad. I remembered walking past the patient who then smiled and called me over to her. Her last words to me were “So long as I’m home soon you’ll make me happy”. I knew that her discharge plan with added social input was in process, so I simply smiled at her thinking that this would be the last time I would see her.

I was shocked to find when I returned from my travels, that unfortunately life had demonstrated once again its unpredictable nature.  The once able, good-spirited lady had become a frail and visibly unwell patient. I was absolutely devastated by this. During the week I was on holiday she had suffered a fall and subsequently developed pneumonia that was not responding to antibiotic treatment. Therefore she had become confused and was not able to articulate her sentences with her cheeky charm like she once used to. Within a week she had deteriorated at an incredibly fast rate with her kidneys now failing. In a cruel twist of fate, she had become palliative.

As I recall the events, I am saddened, mainly because I developed a small emotional bond with her as a patient and also because this made me realise that elderly patients knowledge and spirits are precious. Unfortunately elderly patients are so vulnerable to infection, due to their ageing immune system that as clinicians we must be vigilant when there are symptoms and signs of infection, therefore clinical staff must act promptly on any clinical suspicion.

Earlier I mentioned that this patient raised her concern asking, “why do you keep fixing me?” As I reflect on this case, perhaps this patient had simply fought the good fight and was ready to hang her shoes up for good? Perhaps she knew that her time was near and she was ready to go? Perhaps?


Her story highlights how life is both precious and fleeting.


See other articles in this series:

*     Where There Is A Will, There Is A Way.



Posted by under Knowledge & Careers, Mind, Body & Soul

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