A Sliver of Hope

It's 9pm and I'm on nights once more. There are no emergency operations to do, so I'm in the intensive care unit, helping out as best I can. Bindhu is the registrar on call tonight and is my direct senior for the shift. We’re walking round the unit and she’s giving me a brief handover of all the patients as we do so.

We pause at the end of one of the beds and I recognise the lady in it. It’s Mrs Campbell. Last week, I’d pre-assessed her for her emergency operation and then handed over her care to the anaesthetist on call during the day time. I smile at her and receive a tight grin in return.

"You won't get much out of her," says Bindhu. I give her my best "quizzical" look, so she elaborates. "It's a bit strange. Every time I try to speak to her she won't answer me, or even acknowledge me, but when I watch her with the nurses, she seems to be completely different. Mind you, she's apparently been a bit better today. In the daytime, they made the surgeons come down and explain to her what went on - or should I say, what went wrong - with her operation and explain what they're planning to do about it. I mean, it's only fair isn't it? I don't see why we (anaesthetists) should have to take the flak, when really the cause of her problems is nothing to do with us."

"Indeed." I reply. "I'll bet you that I can make her smile though."

Bindhu throws her head back and gives one of her lilting little laughs. “Good luck with that,” she says and we move on to talk about the next patient.

It’s now 11pm and Bindhu and I have done all the pressing things for all our patients on the intensive care unit. The nurses have just turned down the main lights, so the room is illuminated by soft glows coming from the lamps at each patient's bedside.

I walk up to Mrs Campbell’s bedside.

“Hello. Mrs Campbell,” I say softly. Her eyelids flicker open and she fixes me with a cool stare. “Do you remember me?” I continue.

She rolls her eyes away from me. “No. I don’t remember you,” comes her flat reply. “I don’t remember… anything. For the last few days, I don’t remember anything.”

This doesn’t come as a surprise to me as she’s been in a coma on a ventilator until a couple of days ago, but I suppose I was hoping that she’d at least recognise me from before her operation. I was wrong.

“My name is Michael, I’m one of the anaesthetic doctors and I saw you before you had your third operation. I just wanted to see how you are feeling.”

“How I am feeling? How am I feeling?” she seems to ponder the question for a while, like she’s rolling the thought around her consciousness. “I feel lousy.”

And then there’s The Silence.

I like to think of myself as a pretty chatty, outgoing person who can talk to just about anyone, but every now and then, I find myself at a loss for anything to say at all.

Here I am, late at night standing next to a woman with several tubes coming out of various parts of her body. A woman who’s just come out of a coma and is too weak to even feed herself. I feel that there’s just no way that I can relate her and what she’s had to go through. There’s no way that I can understand how she must be feeling. There’s no way that I can put myself in her position or even begin to imagine what it must feel like. I fear that any words of comfort that I might attempt will sound trite in the face of this lady’s experiences, so I’m left with no words at all – just The Silence.

As The Silence stretches on, it begins to feel more and more uncomfortable. I’m just standing next to her bed saying nothing, feeling stupid, so I’m compelled to try and just say something, anything at all.

“Yeah, I understand that you must feel pretty lousy right now. Am I right in thinking that you’ve been able to have a chat with the surgeons about the operation?”

She sneers at me. “Oh, I know what they’re planning to do tomorrow. And I know what they’ve done.” She looks away from me again and stares in the direction of the far wall, which has silver tinsel draped along it. “They’ve given me a stoma.” She spits out the last word, like it’s a piece of rotten fruit she’d accidentally bitten into.

She looks back at me now and meets my gaze. I realise for the first time just how piercingly blue this lady’s eyes are. She sighs. “My sister had a stoma,” she says, her voice is a mere whisper.

“And you really didn’t want one…”

“I cared for her for years… For years. That’s her picture over there.” She gestures to the photo frame at the side of the observation chart. I go and pick it up and look at the picture.

“What happened to your sister?” I ask.

“She had MS. And cancer. I spent years looking after her, and looking after my mother. We were inseparable, you know? And do you know what’s funny? During all the time I was looking after her, I knew that there was something wrong with me. But I had to be strong, you know? For her. I’m a very determined woman. But I knew there was something wrong. But I never thought I’d end up just like her.”

“I know this is easy for me to say,” I respond, “but you must try and stay positive. You are getting better. I know you must feel awful now, and there’s a long, long way to go, but, hopefully each day you’ll feel stronger and, as you do so, you may be able to look forward to the future. You’ve just got to try and think…”

“That God knows what he’s doing?” she interjects.

“I guess so.”

“Last Christmas was hard…. very hard. My mother died. She kept saying ‘I want to be with my daughter. I want to be with my daughter’ She kept saying it again and again…” Her voice trails off and tears well in her eyes. “And now she is,” she whispers.

“I saw her last night, you know,” continues Mrs Campbell. “My sister. She was stood over there near the door…”

I wait for her to continue, but there are no words coming. Once more The Silence envelops the two of us.

“Yesterday, I didn’t want to live,” she says. “I’ve got nothing left to live for. Yesterday, I really didn’t want to go on. But today… Today I feel better. I’ve got a dog, you see. I have a little dog that loves me, and I love her. So I’ve got to get better haven’t I? For my dog.” She gives a little laugh. “That dog saved my life.”

“That’s something,” I say. “And as you get better, and are able to do more things, then I’m sure things will start to look brighter. I’ll leave you to get some rest now, Mrs Campbell. Sleep well.”

She closes her eyes and I walk away.