Monday, 12 July 2010

Sometimes my voice annoys me

I watched her bottom lip as I spoke. My voice dropping involuntarily to the soft calm tone as I explained, as simply as possible, the concepts that I had called her to the hospital to hear.

She smiled as I spoke, in that brave way that someone who is trying desperately to be strong smiles. In that way where you're hearing the words but hoping against hope that you're not hearing what you think you're hearing.

I looked at her young skin, the braces on her teeth, and the way that her bottom lip quivered involuntarily as she nodded and listened and tried vainly to keep it together.

I was there hours after I was supposed to be, sitting in the family room with a nice family of a nice man, wishing I was at home with my own family, trying not to let my own lip quiver. Desperate to do this right, knowing there is only one chance to break bad news, and that it can be done so very poorly.

Telling a family that their Dad is going to die. Soon. That I'm sorry but it could be tonight even that he deteriorates and slips away. That I know that he's a stubborn old guy, a real "she'll be right", suck it up and get on with it bloke. But that as he's known for a while, that it's ending, and I thought you should know.

Trying not to overidentify, trying to work out if touching her shoulder when she finally broke was ok. Seeing myself reflected in her. Trying not to pretend to know how she feels. Reminding myself that every situation is difficult.

Maintaining the calm soft voice. Clearly laying things out, feeling shamed as I realised for a second that I felt pride in how well I was doing this breaking bad news thing as I reminded myself that this is not something that I ought to feel proud of. Feeling the relief at least that I was communicating clearly, that there was no misunderstanding of what I was saying.

The emptiness as I walked away from the room, confident that I'd done the best that I could do, but feeling inept, that my best was not enough. That I hadn't been able to make it better.

Drained and tired and spent, directing the deaf cabbie home in a numb fog to hear the Possum screaming from the front gate. Rocking him in the middle of the floor, talking and singing in that exact same soft calm voice; his damp sweaty head thumping forward into my chest as he begins snoring.

Holding him, heavy and flaccid in my arms and watching his future flash in front of me. Realising that life continues on, but that one day his body will fail too. Wondering how his family will feel when someone is having *that* conversation about him. When the soft calm words aren't to help him sleep but to tell those nearest him that he is approaching the forever sleep.

Sometimes this job is so hard.


kalita said...

I don't think you should feel ashamed of breaking the bad news 'well'. It is a vital skill, in your profession.

I was going to write something about my own experience but it's depressing so I won't :)

Melissa said...

It is something to be proud of. The callousness with which we were treated will forever burn at me, a scar I don't think will ever heal.

The palliative care nure who came to our home and helped us, looked out for us is one of the few good memories I have of that time. Her name is Sue and I will never forget her.

Be proud. They won't forget you. It will always matter to them.

Sarah said...

I too would like to say that being able to break bad news the right way is such an important skill. As you wrote, it is not something that comes without a lot of thought and effort. I think it is OK to be proud of being somebody who is willing to put that thought and effort in to do a difficult thing as well as it can be done.

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Jodie said...

Make sure you have someone you can talk to, to let it all go, if this blog isn't enough.
I honestly don't know if it gets any easier. I think you get better at losing the personal need to 'fix things', to 'make it better'. It still bruises my heart each time I have to have these conversations, but I'm getting better at it, more comfortable at making conversations flow and discussing those uncomfortable topics.
End of life is such a priviliged time to share with families and to do it with compassion and kindness is something they will never forget, so bless you for your beautiful approach to such a difficult time xxx


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