vendredi 17 juin 2016

Dying at the right time…

For year (unfortunately) I have been witnessing sick patients and their families, their thoughts, their reactions, facing a death, might it be imminent or not. I am a witness to their astonishment, I listen to their concerns. I measure their always existing feeling of injustice, regardless of the circumstances.

The relatives of bereaved individuals try to alleviate their misery. But these attempts are often inadmissible: he was old, he suffered, he drank too much... these can even be downright inappropriate: you'll find someone else, you're still young... or even worse, the comment suffered by the character played by Jessica Chastain in the Tree of Life: you have other children...

So I asked myself this question. When do we consider a right time to die, while we still have time, and is it never the right time? Never?

What death seems acceptable? At 80 years of age after a pulmonary embolism and without having suffered? If our physical condition is considered too unbearable and it is no longer compatible with life? If you become dependent?

Is our age a parameter? Maybe our achievements? Our ongoing medical history? Possibly the conditions of our death? Or maybe the people we will leave behind? Who deserves to live a long life and by what criteria?

I think back to a 69 years old patient of mine; of whom I took care of in the hospital. She had cutaneous lymphoma followed by an extension with multiple metastases, pulmonary, cerebral... She had been fighting thus far, but the disease had taken over. She was slipping into a coma, little by little. She was dragged down. Her son was warned, he was coming. His coat still on his back, he just had time to kiss her on the forehead, telling her he loved her, to tell her goodbye, then she stopped breathing and we declared her death. As if she had waited for this moment to leave.

More recently, in my office, I received an old lady, 90 years of age and in very good physical condition, no history, no treatment, no follow-up.

Her right breast was hard as stone, retracted, covered with skin metastases, an advanced form of breast cancer. We also perceived axillary metastasis. She sensed my confusion but did not say anything. Her doctor had taken an appointment, without her agreement, to meet with an oncologist for treatment.

Then I received a message from the oncologist, stunned, a few days later telling me that she had not come for her appointment. She did not inform me of her decision to do nothing, since she had easily guessed that there was really nothing to do, nothing effective, at least. She had preferred to choose rather than to suffer. Who would blame her? Must we always do everything we can to delay event?

And, of course, I do not mention here the violent circumstances of some deaths, since I have very little experience with the criminal context in forensics.

Like Joe Cox, Labour MP, whose life was cut short apparently because of her political ideas, is going to haunt the lives and nights of a whole country.


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