The Patient (24 page)

‘I see 18-year-old boys dying down in Emergency. I see 80-year-olds dying too. We're all on the same journey. What we don't know is when. Tracy, we cannot make each other live forever.'

She was sobbing fiercely now, grieving that her husband was going to leave her much sooner along the path than she had ever envisaged on their wedding day.

‘Are you sure there is nothing to be done?' She covered her face with her hands.

‘Tracy, I really don't want any more. I need to live. I need to have some life before I go.' Jonathan was standing his ground.

I went and rang the oncologist and explained the situation. He agreed with me that it was truly clutching at straws to make him undergo the triple-therapy regime. He suggested a script of steroids, in the form of dexamethasone, which would reduce the pressure in his skull.

I returned and gave Jonathan the script, then asked him, ‘Is there anything that you would like to do before you die, Jonathan?'

He looked sidelong at Tracy. ‘I would love to go to Paris again. Do you think it would be OK to travel, doctor?'

‘They have great hospitals in France, Jonathan.' He shook my hand firmly as I farewelled him for the very last time.

The check-in clerk at the George V Hotel realised immediately that the guest in front of her was not well. His patchy hair, his slow and deliberate walk, his wasted frame. She excused herself, spoke to her manager and returned with the good news that they had been upgraded to a rooftop suite. Tracy thanked her effusively, and the concierge took their bags.

‘I love the smell of this place.' Jonathan was in seventh heaven. As soon as they got into the room, they rang the girls. They had thought about bringing them, but this was Tracy and Jonathan's time.

Early evening, they went for a walk down the Avenue George V and on to the Champs-Elysées, past the pen shop where, years before, Jonathan had splurged on his collector's edition Dupont fountain pen. Life was as it should be. There was a cooling breeze in the air. They found a little cafe and ordered a coffee. He was breathing in the air, taking in the sights, absorbing the atmosphere.

Tracy's attention was dominated by one thing: her husband, her soulmate. She was trying to commit each
moment to memory – the feel of his hands, the subtle touch of his lips on hers, the baritone voice that was always just slightly too loud. They had laughed a lot so far on their holiday but cried even more.

He tired quickly, but each day they were able to go out and see one of the sights that brought Jonathan joy.

He sat for hours watching the priests and nuns of Notre-Dame preparing for the morning mass and sat in a pew behind the worshippers, staring at the beautiful statue of the Virgin Mary with her newborn infant. He took Tracy's hand, and they lit a candle. For the first time in many years, Jonathan said a prayer. It was short and to the point: ‘God, if you do exist, look after my wife and girls when I'm gone.'

Tracy knew there was one very special place where Jonathan wanted to go, and she booked a car for that day. Giverny was a fair drive out of Paris. As they walked its narrow pathways between neatly planted beds of flowers, they marvelled at the colours.

When they returned that night to the hotel, he slumped with exhaustion. ‘I'm ready to go back home, Tracy.'

A couple of days later, Jonathan sat on the porch of his father's home on a recliner. A blanket covered his legs, and a vomit bowl was within reach. The home palliative-care team had swung into action with advice for Tracy on how to keep him comfortable. The nurses visited once a day and helped to shower him and toilet him. He was hardly able to care for himself now. On the table next to him was an iPod connected to some speakers, through which he played his favourite music. As each day passed, his condition worsened.
He lost the use of his right arm first, and then he found it hard to walk. Within days, he was slurring his speech and dribbling from the side of his mouth. His father and Tracy took it in turns to look after him and the girls. This was the intractable irreversible slide into death.

By the middle of the second week at home, Jonathan had lost control of his bowels, and his behaviour had changed drastically. He could not tolerate his daughters making any noise at all and would get angry at the slightest change to his schedule. He needed a constant vigil. The toll on Tracy was inestimable. She was exhausted, hollowed out, empty, gaunt. Her eyes stared out at the world from dark racoon circles.

Tracy and Mr Brewster had long and difficult conversations with the palliative-care doctors. Should he be transferred back to the hospital? Perhaps the hospice was the best place for him?

Jonathan's father refused all such suggestions. ‘My son wants to die at home. I'll look after him if no one else will. Thank you for your help. We do not need it.'

The smell of death hung around them like a black ring of smoke, seeping into every brick, every wall and every piece of furniture. At night, all that could be heard was the grunting of a dying man. Occasionally, he would yell out in his sleep, shouting at invisible memories, crying at hidden nightmares and calling to the ghosts of his past.

As dawn came at the beginning of the third week, Tracy was awakened by a gurgling sound that she had not heard before. Immediately, she realised what was happening. Jonathan's father was then awakened by the sound of Tracy's sobbing and Jonathan's gurgling. He also knew what time it was.

He entered his son's bedroom, now converted into a hospice, and went past the bin full of used tissues and the large oxygen cylinder. He placed his hand on Jonathan's head. Jonathan was grunting and gurgling, moaning from time to time. Mr Brewster could see the veins in his neck still throbbing with his heartbeat and his chest moving air in and out.

Within minutes, Jonathan was still – free of life and of pain.

To look at the house from the street, one would see nothing amiss. The birds chirped their morning tunes. The suburb slowly stirred as the glow of pink and yellow hues in the sky dismissed the darkness once again.

In the Emergency department of the Victoria Hospital, a stream of patients had entered throughout the night with their ailments, their tragedies and their suffering. The health minister was about to go on his morning walk, and Jonathan's surgeon, Derek, was already starting his morning ward rounds. The night nurses were clocking out, ready to leave, and the night doctors were documenting the saga of human woe they had witnessed. Ahmed was reciting his dawn prayers, and Mr Sharma was chanting his.

The Earth hurtled in its graceful and speedy journey around the Sun, and the Milky Way turned another couple of degrees relative to the silent universe, where nothing from Earth was ever heard.

All was as it had to be.

And he said, ‘Come, oh beautiful Death; my soul is longing for you. Come close to me and unfasten the irons of life, for I am weary of dragging them. Come, oh sweet Death, and deliver me from my neighbours who looked upon me as a stranger because I interpret to them the language of the angels. Hurry, oh peaceful Death, and carry me from these multitudes who left me in the dark corner of oblivion because I do not bleed the weak as they do. Come, oh gentle Death, and enfold me under your white wings, for my fellowmen are not in want of me. Embrace me, oh Death, full of love and mercy; let your lips touch my lips which never tasted a mother's kiss, nor touched a sister's cheeks, nor caressed a sweetheart's fingertips. Come and take me, my beloved Death.'

Kahlil Gibran, ‘A Poet's Death is His Life'

To be a surgeon is to stand, without flinching, in the sea of human suffering and use one's entire resource of knowledge, skill and intelligence to battle it.

 

An intern makes his first cut and is ridiculed by his tutor. An old woman is brought back to life against her will, only for the unexpected to happen a week later. A notorious surgeon is sent crazy by a massive brain tumour. The mother of a leukaemia-ridden child is driven to desperation …

 

In this compelling and beautifully written impressionistic memoir, Mohamed Khadra recounts stories from his life as a surgeon, from the gruelling years of training to the debilitating sleepless nights on call. He looks back at the doctors and patients who have shaped his career; at the endless stream of humanity – courageous, pitiful, admirable and dislikable – who have passed under his knife, as he recalls shocking tales of mistakes in theatre and the shattered lives of doctors defeated by the stresses of the job.

 

Documenting the damaging politics in our health-care system, the soul-destroying choices made for patients and the misplaced hope so common in the face of death, his dramatic account of a surgical life shows what happens when extraordinary events overtake everyday lives – including, even, his own.

 

‘Unputdownable … I read the book straight through one night …
A tough-minded book, but also full of love … Compelling
and memorable'

Australian Literary Review