My brother Paul had been diagnosed with advanced pancreatic cancer that had spread to his liver.
Wednesday, he was told by his GP that he would benefit from palliative support. On Thursday morning the oncologist told him that chemotherapy was not an option and had palliative care been in contact? Thursday afternoon palliative care arrived and told him that he did not need palliative care. Thursday was a ‘good’ day and he presented well.
On Saturday morning I found him asleep sitting in his chair, in the same position that he had been in the night before when I left him. I had read that cancer patients sleep a great deal and thought that he was doing just that. I had been concerned about his breathing, which was six breaths a minute and quite erratic. He was restless.
By late afternoon I tentatively called a number for palliative support and was told to call 000. An ambulance arrived. Paul was aroused and cried when he saw three paramedics in his lounge room. He could not answer questions easily as his speech was very slurred. After an assessment it was decided that Paul be taken to hospital as it was not clear what was going on. Could he have had a stoke? ...not sure.
In the emergency room he was very stressed and frightened. A blood test confirmed an infection in his liver. His kidneys were failing, as well as a thought that the cancer had gone to his brain. Paul was put on fluids and antibiotics, which were both stopped the following day when I had spoken with the doctor stating that I wanted Paul to be made comfortable and allowed to pass with dignity. 41 Bearing witness I made the same request for my father when he was diagnosed with lung cancer a few years earlier. He was given two doses of morphine and simply went to sleep, never to wake.
Paul deteriorated over six days. He initially had periods of long sleeps, waking for a short while and recognising me and my cousin. Then the sleep periods became shorter. He would wake up suddenly with the most terrified look in his eyes. He did not indicate recognition of anyone but groaned as he reached out with his arms in pain.
He was having difficulty with congestion, coughing, and was weak. “His eyes, a sight I will never be able to get from my mind, showed sheer terror as pain wracked his body ” A pump providing regular bursts of morphine was provided and sedatives given but they did not have any desired effect and, in my mind, were not given quickly enough. Medication was administered only when Paul was in agony rather than topping it up before it got too severe. Once given it took a good 30 minutes to kick in. The morphine pump was again increased, as it was clear that nothing was keeping the pain at bay.
More shots of sedatives were given every hour but nothing seemed to work. Paul was moaning and his arms were reaching out in agony, his hands clutching in fists. His eyes, a sight I will never be able to get from my mind, showed sheer terror as pain wracked his body.
I felt so guilty that I had stopped the hydration and antibiotics, knowing that the effect of this was contributing to his pain. He was sweating but felt cool to touch. A tear welled in one eye. He began breathing so hard that I couldn’t understand how his heart could take the strain. My cousin questioned the fact that he must be hyperventilating which in turn would have added to his distress.
I was sobbing and pleading for help…to do something…let me sign something…I wouldn’t let an animal suffer so! I have never been more frantic and felt so utterly useless. I could not help my brother and I just wanted to run away. I couldn’t even pump a fatal dose of morphine into him as the pump was locked up solid within a casing, the keys locked away in a cupboard somewhere.
For six hours this went on.
Even the darling young nurse looked desperate as she explained hospital policy.
Suddenly the frantic breathing just relaxed and he was gone… just like that! It was two whole days later that I suddenly asked myself why I just didn’t smother my brother with a pillow. To be honest I didn’t think of it and was disgusted with myself. I would have… it would have been far more humane.
My brother was such a sweet man and should never have had to suffer such a dreadful death. He was so petrified that I can only believe that he must have had a premonition of what was to come. I too am a coward who cannot stand pain and will help fight hard for voluntary euthanasia.
I don’t want my children to witness my suffering in agony, choosing rather a more dignified and pleasant end to life.
Sue Hayward, first published in The Damage Done, August 2016