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Monday, November 21, 2005

Diary of a death Part II and fin.The Diary of a death - Part II

The Diary of a death - Part II



19th Feb 93: No change in the condition today. Kate is not being sick, and although very weak, she was able to sit on the edge of the bed for a while. The Nurse inside her told her to try and move a little to avoid “bed-sores”.
20th Feb: She slept solidly, otherwise no change. A period of relative calm over 2 days.
PM: Bad afternoon, Pains and increase of morphine. The new Doctor Hornimann may not be entirely in the picture, since he had attempted to reduce the dosage.
21st Feb: This was the worst night and morning.Kate is back onto the food drip, and is still suffering pains.
PM: Doctor is not available/present, and the pains are getting worse. Kate is very down and depressed, and seems to be on the outmost limits of consciousness
22nd Feb 93: Phone call in early morning from Hospital, fears for Kate’s life. No sleep, fever, back onto oxygen. The Doctors raised the Valium. This should have been done before, but the non-presence of Doctors at given moments is pre-occupying. Since the entry on scene of Dr Hornimann, the situation has rapidly got to the end point. He reduced the Morphine and Valium dose, he was not available on many instances, I have almost the feeling that the Hospital have bowed (as both I and Kate have earlier) to the inevitable, and have taken the chance to end the story, by the introduction of a Doctor and Nurses unknown to Kate, and Kate unknown to them. I can’t forget that Kate was, after all, the head Nurse of this very ward, where she has been a patient for so long, and where she will die. This could not have been easy for the Doctors nor for the Nursing staff, but now the inevitable changes to Staff and Doctors has taken place, and this was accompanied by an extreme worsening of my wife’s condition. That she will die, is inevitable now, but I was forced to put, very pointedly, with a language very understandable, to the Doctors and a couple of Nurses, that although I now accepted that, I did not, and would not accept the fact that their efforts be reduced. In particular concerning the pain factor, no reduction in anything would be made in future, without the control of the Doktor Berger, who had been promoted, and now had no direct function with the case. I pointed out the circumstances, and it was agreed that Dr. Berger would be consulted in any further treatment. Both I (and more particularly) Kate had a certain amount of confidence in this Dr Berger, who had done a maximum, and had gone as far as to “suggest” bad practices in the Operating Theatre by the Chief Surgeon, who had insisted on carrying out this operation on (as he called her) “his little English sister”. Bad operational methods and practices had apparently led to a spread of the cancer, and not to the end of it.
(There are more details of this at the end of this diary).
22nd Feb 93 PM: The decision to give heavy sedation was taken by the medical staff.
Shortly after, Kate was no longer speakable to. Morphine 800 Valium 80.
23rd Feb 93: Very sleepy, highly sedated – no communications, just a gasping noise, until the oxygen mask installed. Kate is going downhill very fast. She can’t speak, has all the appearances of an “artificial coma”, but nobody can tell me whether she can hear me, if she is aware of my presence or not. So I just talk.
24th Feb 93: This morning Kate was conscious, and we heard from the medical staff the decision, and were asked if we (more Kate than me) were in agreement. Due to pains, and other problems, it is proposed to sedate highly, in an attempt to “improvement through sleep” that is to minimize the bodies efforts, and let it concentrate on its own healing procedures. They know, I know and Kate knows, that this is what amounts to the final step.
When the Doctors/Nurses/Experts had left, we had the opportunity to talk a little together, although there is little to talk about. Kate tried to give me her wedding ring, now far too big for her finger, but I suggested that we tried it on all the fingers, and if necessary even the thumbs! We found finally a finger thicker than the others which held the ring in place. I was relieved, and Kate was too. She asked me for some more of the “Perrier” zest water, which I gave to her, and said I would bring some more in, this afternoon, since there was very little left.
PM: I returned after lunch with the water, and realized that it would not be needed. Over the lunch period, the Medical Staff had increased the sedation, and my wife was now in what I can only call a “trance” or comatose stage.
Valium is now 120 and Morphine 1000. Consciousness, I am told, is not possible under such doses. I was extremely displeased that this action had been taken in my absence, and that we had not been told. We could have made at least a final farewell. Had my wife not been in her condition, I know I would have physically attacked certain Doctors, and they knew that too.
Kate’s condition is no longer of this world. Her body weight has gone from some 55 kilos to 38 kilos in the last 3 weeks, she is in a coma, artificial yes, but nonetheless a coma. All I can do now is be present as much as possible, and hope that nature will take it’s course, either healing or killing, but any normal mortal can only support so much.
25th Feb: No change – Kate is still unconscious. General condition very bad, but her facial features show a tranquility which suggests that no pain is present, and that the dice have been thrown and the result accepted.
26th Feb 93: No change, I feel that she has left us in all but shallow breathing. I understand that the Valium and Morphine levels have been raised again.
27th Feb 93: Apparently Kate was “restless and uncomfortable” (the Nurse’s words) after her morning wash, and became slightly conscious. When I saw her, she seemed to be at peace, but became a little agitated and then very upset, until we both figured out that what she was trying to do was to say “Good Morning” to me! The love of this woman is enormous, and I reciprocate it. One of my problems right now, is that Kate has her birthday on the 7th March, and I firmly believe she is trying to survive till then. What do I do, is there any point in arranging gifts, cakes, etc?
28th Feb 93: I was called at 5.45 and when I arrived, I found no change in particular, her feet were very cold (a circulation problem?) and her breathing extremely irregular. She is unconscious, and shows no reflexes.
1st March 93: This “coma” condition continues. There are no reactions, except at washing time. Strangely enough, her stomach is much less inflated, her “bag” is working, even although she is on the liquid drip nourishment. Her breathing and pulse are however extremely weak, and irregular.
2nd March 93: No change in general condition. To the total disbelief and astonishment of all (me included) the urine and faeces are now coming from the correct places. No apparent reason for this. Kate is still comatose.
PM: No change, breathing shallower and gasping.
I have informed the staff (and Kate – if she hears me ) of my whereabouts tomorrow morning – I shall be in the Hospital, but in the Cardiac Dept, having an appointment for myself. If anything untoward happens, they can call me there. Life goes on – although it is of little interest to me personally what is to be done with me, it appears that the Doctors are keen!


********** 3rd March 1993 **********
Kate died at 0030hrs this morning,
and I died with her.


After a long and careful consideration of my personal position from the 3rd March 1993 onwards, I think I can say that the events leading up to this date, and the death subsequently of Kate, were also my destiny, and I effectively lost interest in the act of living from then on.
I was able to reject all treatment for cardiac and other conditions, was able to lead a relatively full life, mainly for others, arranging meals, parties, holiday events etc, for as many people as possible, on the basis that for me it was finished, but for them, their lives were still in full swing, and they should not be influenced by ANYTHING. If life is there to be enjoyed, then enjoy it in your own individual fashion.
I have no final thoughts, except that I have tried to remain faithful to the agreements made between myself and my wife, Kate, particularly in matters regarding religion, priests, minister’s prophets etc. I have tried to arrange the non-participation of any religion on the occasion of my death. I have left instructions that my body be donated to Science, or in the case of non-recognition, be cremated, with no ceremony of any religious variety, just as for Kate, whose urn is to be found in the cemetery at Lorrach, in Germany, and I look forward to rejoining her, not in the cemetery, but in spirit.


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Details regarding certain professional physicians in Germany
Most of these details were given “ad-hoc” to me by other medically involved people, after the death of my wife.
Some of the details only came out after her death, some had been overlooked at the time:
The “Oberartzt-Chefartzt” in Lorrach who had carried out the initial operation, and who had been accused on various occasions of malpractice (it always concerned his own state of health) effectively committed suicide some months after the events.

The “Professor-Professor-Dr.-Dr.” (and he used all these titles!) retired expert from Basel in Switzerland, who was called in by Dr Berger for an opinion, was about as useful as a Swiss cheese, full of holes, would be as a boat. An old retired, man, still, true to Swiss traditions “in it for the money” and who loved the “authority” and “respect” he believed was shown to him.
He too died some months after the death of my wife.

The indignities suffered at the University Clinic at Freiburg, Germany, who installed my wife, together with around 10 other women (all at the same stage, roughly) into a room with no windows, 4 walls, bare, and two doors, one double size (which allowed the passage of mortuary trolleys) and one single size which allowed the passage of people who had “escaped”.
These things were all changed rapidly, within 2 days, after I had taken the pleasure of explaining to the University Clinic Administration in my best (which means worst) Bavarian what I thought of them, their clinic, their attitudes, and what I planned to do about it.
One other thing on the positive side, Dr Berger. A dedicated professional, who often put himself into hot water for his patients. He was promoted (as stated in the Diary) and no doubt made his way in his profession. My wife, and I had immense respect for him and his attitude, and although it was he who suggested (almost pleaded) with my wife to go to the University Clinic Freiburg, to avoid the operating tables in Lorrach, he couldn’t have known of the conditions at Freiburg.

So the story is finished, and if I get the chance and pleasure to meet you all again, I shall still be trying to lead the life I chose, with my wife, and not one imposed upon me by others.

END

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