It was a busy night in the emergency department, as usual. I rushed from one patient to the next, trying to keep up with the constant stream of people coming in with various ailments and injuries.
One patient, in particular, stood out to me that night. He was an older man, probably in his early 70s, who had come in complaining of severe back pain. After a thorough examination and some tests, we came to the conclusion that he was suffering from cord compression, a condition where the spinal cord is compressed by a narrowed or damaged spinal column.
The man was in a lot of pain, and we knew that surgery was necessary in order to relieve the compression and stop further damage from occurring. We gave him decadron, a powerful anti-inflammatory medication, to help reduce the swelling around his spinal cord, and called in a neurosurgeon to perform the necessary surgery.
After a few days of intensive care, the man began to show signs of improvement. His pain was subsiding, and he was starting to regain some of the mobility that had been lost because of the compression. It was a long road to recovery, but we were confident that he would make a full recovery with time and care.
Weeks later, I received a new patient in the emergency department – a middle-aged woman who had come in with septic shock, a serious medical condition in which the body’s immune system goes into overdrive and attacks its own tissues and organs. She had a long history of end-stage renal disease and had been on dialysis for several years. She also had a variety of autoimmune disorders, which made her particularly susceptible to infections and other complications.
We ran every test we could think of, but we couldn’t find the source of the infection that was causing her septic shock. We started her on broad-spectrum antibiotics and gave her plenty of fluids to help support her body, and slowly but surely, she began to improve.
Days turned into weeks, and I found myself caring for this woman again several months later in the ICU. She was a fighter, there was no doubt about that – despite all of the challenges she faced, she managed to maintain her strength and resilience in the face of all odds.
Then, one day, everything changed.
It was the ninth day of her admission, and I walked into her room as I did every morning to see how she was doing. But when I asked how her night was, she gave me a surprising answer.
“I want to pass peacefully,” she said, her voice weak and tired.
I wasn’t sure what she meant at first, but as she started to explain, I began to realize that she was ready to let go. She was tired of the endless hospitalizations and treatments, tired of the constant pain and uncertainty. She wanted us to stop all of the painful and invasive procedures, and let her pass away gently and peacefully.
It was a difficult decision to make, but after consultation with the palliative care team and her family, we began the process of withdrawing care and transitioning her to an outpatient hospice facility. It was one of the hardest things I had ever been a part of, but I knew deep down that it was the right thing to do.
The day before she left, I saw someone being rolled in a wheelchair right in front of me that I could hardly believe my eyes were seeing – it was the elderly man I had cared for just a few months prior. I rushed over to him and asked if he remembered me, and his face lit up in recognition.
“Hi Dr. La! You cared for me last November when I had my spinal cord problems!” he said. I quickly found out he was visiting his daughter, the elderly woman I was caring for.
It was surreal to realize that I had cared for not just one member, but two members of the same family in just a few short months. Here was the father, reaching out to support his daughter during her darkest hour, just as he had relied on us during his own.
It wasn’t an easy journey, but I knew that both of these patients had received the best care possible during their time with us. And despite the sadness and heartache that came with the end of their journey, I was grateful to have been a part of their lives and to have made a difference in their final moments.
Ton La, Jr. is a physician and can be reached on LinkedIn.