BMJ  2003;327:206-207 (26 July), doi:10.1136/bmj.327.7408.206

Commentary

mother's response

¹ Department of Palliative Medicine, Royal Marsden Hospital, London SW3 6JJ diane.lavarty{at}rmh.nthames.nhs.uk

My husband and I had been estranged for about six years when our son became ill. Despite our separation, we always communicated about decisions relating to our son's care.

The night when he began bleeding is etched in my memory. The most poignant thing is my recollection of my son's face. He looked absolutely terrified. After his condition stabilised, we (the family) left the room to discuss the situation with the doctors. They explained that if the procedure was not performed immediately he would not live through the night. My husband and I spoke about it and he was keen for us to proceed, but I pointed out that it needed to be our son's decision. I recall discussing what would happen if they couldn't find a bed anywhere for him. The whole incident felt like torture for all of us.

I don't think I thought about the futility of the situation until later. It was not until the next day that I was told that it wouldn't be appropriate for him to have a procedure like that again. I realised then that there had been an element of doubt about the value of such an intervention, but it was difficult for me to comprehend because the procedure had left my son feeling so much better. I do not know how I would have felt if the procedure had not gone well.

After the procedure, we were able to spend a happy weekend with him. He then became very drowsy but he was also settled. After several months of seeing him constantly in pain, it was such a relief to see him peaceful. We all agreed that he was so much more comfortable. Although he was unable to communicate, he did give us indications that he was aware that we were present. I do not know what my husband's innermost thoughts were during the course of the illness as we talked about only factual issues, but in the end I feel sure that he had come to terms with the imminent death.

Those last two weeks allowed us the opportunity to accept the situation and prepare ourselves as much as possible for his death. If he had died on that night, it would have been much more traumatic for us and his death would not have been so easy to come to terms with.

Lynn Boland

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Competing interests: None declared.

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Emily Jane Woo
bmj.com, 25 Jul 2003 [Full text]