Communication

You never know what direction a palliative care consult may take.  Our team got involved with a 40ish man with a rare condition. He had Berger's disease, which is a disease of blood vessels that can be very painful.  In fact his fingertips had auto amputated- basically died- leaving just the nail sticking out by itself.  Another problem with this disease can be forming clots. He came in the hospital needing surgery for some clots in the vessels in his legs and ended up having multiple strokes, leaving him in a coma state, unable to wake up, talk, etc.  That's when we came on board.

What makes this story unique is the family. We had a family meeting and the patient's son and extended family decided to move to comfort measures- meaning we'd stop all the extra meds we were using to prolong this poor man's life, and let him die naturally. They all talked about how miserable he'd been with this berger's disease- always in pain, and getting worse and worse.  They new he'd never recover from these massive strokes, so the best thing was to make him comfortable.

As extraordinary as it might seem, this same son attempted suicide last night at 8 o'clock, and unbeknownst to him, his father died an hour later.  Just as his father was leaving our care, the son was being admitted to the very same ICU unit his father was leaving.  The ICU team and even the psychiatrist that came to see the son all avoided the news about his father...who wants to tell a suicidal person someone they love just died?  That's when I got a page.

"We were wondering if you'd be the one to tell him his dad died...after all you did meet him at the family meeting, and no one else wants to do it"

I guess when you're in a specialty that specialized in communication, people want you to do their dirty work.  So at 3 in the afternoon, 18 hours after his dad died, I knocked on his glass ICU door, took a deep breath and jumped in.  He actually took it okay, was upset and sad, but had expected it... I think he was just happy someone told him.  It might seem unwise to tell a suicidal person about their father's death, but better now while he's safe, being watched like a hawk then finding out later on his own.