Saturday, January 28, 2006

Palliating Ron. Part I

"It's not working, doc"

Dr Dork walked up to the side of the bed. Ron was pale, sweating. He looked all of his 80 years. But he was stoicism personified.

Not a grimace, not the faintest moan escaped his lips. He calmly had answered Dr Dorks query about the new GTN infusion. Who now sat next to the bed to take his BP, negotiating past the nurse recalibrating the fentanyl pump.

Ron had come into the unit the week before. The cancer, arising in his hidden, treacherous prostate, had spread throughout his bones many years before. He had known this was a death sentence for at least a couple of years. It was beyond curative treatment.

Death loitered on the porch, but the knock on the door still seemed distant.

Now his heart had begun quickly to fail. The strain of the cancer had become too great. The cardiologists had done all they could. All that Ron wanted them to do. He needed an operation to fix or replace the heart. But the operations would kill him. He needed the cancer to go away. But it had spread its malignant tendrils far and wide and deep.

All that could be done was to help with his pain.

Normally Rons family was there whenever Dr Dork visited. Today, Dr Dork knew Ron was suffering greatly. So that Ron would not play down his symptoms, Dr Dork had asked them to step out briefly. Ron was dying, but he was more concerned about his wife, his children, than himself.

Ron had been a soldier. A pilot, in the war. He had gone down in enemy territory. He had suffered greatly as a POW. Dr Dork didn't know a lot of the details. Ron didn't like to discuss it, and Dr Dork suspected he had untreated PTSD He suspected this mainly from what the night nurses would sometimes say. Ron had terrible nightmares at times.

Dr Dork had "left the door open" for Ron to talk if he wanted. He didn't think it was likely. Ron had managed his PTSD himself for 50 years. He had worked a farm for decades.

It was coming back a bit, Dr Dork suspected, as Ron suffered anew.

To be continued

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