in between life and death

I have been dealing with terminally ill patients this week. Lots and lots of them.

From general inspection, some of them look very ill, very tired, very cachectic, very bedridden. One of them has got SCC on the tongue. He is not able to talk nor walk. Embolism complicates his case by giving him a pair of necrotic feet. The last time I saw him, he was very angry as he was being put off 3 times for his treatment. Poor man..

The other sad case is a lady in her 40s. Her cholecystectomy was supposed to be a surgery with little complication and quick healing, but unfortunately for her, she has developed serious complications that fail her other organs, especially the liver and the bowel. She is drowsy and confused too, communication with her is not helping much to understand about her condition. When you see her, you wouldn't guess that she's in her 40s, because she looks much older and sicker than her real age.

On the other hand, there's another group of patients who have mobility difficulties but able to communicate well. There's this one man who gave me a deep impression. He has had bladder CA that mets to his lung. Despite the pain and immobility, he chat with us happily, cracked jokes at times. A cheerful and friendly man from outside. Deep inside, he could be very depressed, but we never know.

Rarely, there're patients who look really healthy that you wouldn't expect any illnesses from general inspection (other than weight loss). They stay alert, they are easily communicable, they give full cooperation with medical staff, they walk around, they chat around, they are independent as they are on their own. Unfortunately, cancer cells are silently eating away they life as time passes by. They have cancer and they have mets. Unresectable. What is left for them is just time.

At least, all these patients are not in too much pain, under palliative care.