Transient frailty


As the red highlighter struck through yet another name in my list, my heart lurched a little. It wasn't just a series of alphabets. Every name represented a patient. One who had been talking, breathing, and alive, right until his mortality caught up with him.

I haven't actually met him in real life. But I felt as if I had known him for ages. Scrolling through his past records, and diligently taking note of his medication and vaccination history in my research document, I tried blocking out the non-technical details. Yet, in my mind's eye, I could almost see a tiny frail old man hobbling into the consultation clinic, hunched back, grayed hair. Shrugging his shoulders in exasperation and squinting at the tiny lettering on his medication boxes. Struggling to press on his inhaler with quivering unsteady fingers.

"Patient came with his wife. ADL (activities of daily living)-independent. He seems to be coping well," the progress notes read. "Taught him on the use of his inhalers again."

On the next page: "Patient appeared cheerful. He said he has been compliant to his medications."

Fast-forward a couple more follow-up appointments and a few more years, the next record was a grave one.

It was an admission to the Emergency Department. A severe exacerbation of his chronic lung condition.

Despite the best efforts of the team, nothing could be done to bring him back.

Cause of death: Pneumonia. Non-coroner's case.

The black words, starkly juxtaposed against the white paper, marked a finality.

An end.

Mr X's case was only one among many others, with equally depressing endings.

He was not just another case. Not just another collection of symptoms. He was a man. A living, breathing human. Someone with people he loved and people that loved him.

I finally understood the message that our professors were trying to get across to us all this while.

Remember that we are all human. 

It is impossible to make everything clear cut, shoving all our patients' personalities and human traits aside, and leaving solely the signs and symptoms of their condition to analyse and treat. In fact, we should integrate all these together and treat them as a whole. We should respect them, empathise with them, and learn to understand their wants, values and life goals.

That wasn't the only lesson learnt from this. His passing reminded me of a quote that I've read in a well-written article on death and dying.

There’s no escaping the tragedy of life, which is that we are all aging from the day we are born.

Could it be that the advancements in Medicine in the twenty-first century have made us overly-confident in our abilities to pull patients out of the claws of death? The glorified miracle stories and well-publicised survivor tales have conditioned us to the extent that we are unable to accept the harsh, cold truth that as humans, we are frail. Life is but a transient process that will always end in the natural state of death.

It's about time to change our mindsets, and learn to accept the frailty of life.

*Disclaimer: The case is simply a generic example, one out of many. Much details have been omitted due to confidentiality reasons. 

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