BMJ  2005;330:356 (12 February), doi:10.1136/bmj.330.7487.356

Filler

A memorable patient

Miss Fortitude

When I took her on as my patient, she made it clear that she did not hold the medical profession in high regard. She had worked for many years in a medical students' hostel and had seen us with our youthful exuberance and excesses. She now lived alone on the 10th floor of a tower block, and I always ended my visits to her going to the window to admire the magnificent view over the city.

Her body was crumbling: she was confined to a chair with an osteoporotic spine, and her neck seemed to have collapsed so that her head apparently sprouted from her upper chest at a crazy angle. Yet her mind remained as sharp as a pin: she was constantly pointing out my mistakes or omissions, much to my embarrassment. Our discussions about her treatment and conditions felt more like discussions with a colleague rather than with a patient.

The only family was a nephew in another town, represented by a photograph from the 1970s, the colours taking on strange hues as the event it depicted faded into the past. I was curious to know why she hadn't married, but it would have been inappropriate to ask and I never did.

I had respect and affection for her. Despite her isolation and frailty, she never complained. She rarely bothered us at the surgery, and if she requested a visit I was pleased to go, knowing that it was justified. On her 90th birthday, I took her a card—something I have never done before or since for a patient—knowing that few others would be celebrating that great achievement.

One day, while working for the out of hours service, I received a request to visit. On my arrival it was clear that she was seriously ill and barely comprehensible. There was only one place for her. As I spoke to the admitting doctor on the telephone, I noticed a movement from the corner of my eye. Her arm was moving slowly from a flexed to an almost extended position. Then her body was motionless. After checking her, I told the admitting officer that I would not be sending her in after all.

I felt honoured to have been present with this remarkable woman, my patient and friend, when her life ebbed away.

Marston Medical Centre, Oxford (david.scarfe{at}dphpc.ox.ac.uk)

---

We welcome articles up to 600 words on topics such as A memorable patient, A paper that changed my practice, My most unfortunate mistake, or any other piece conveying instruction, pathos, or humour. Please submit the article on http://submit.bmj.com Permission is needed from the patient or a relative if an identifiable patient is referred to. We also welcome contributions for "Endpieces," consisting of quotations of up to 80 words (but most are considerably shorter) from any source, ancient or modern, which have appealed to the reader.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?