Mrs X

The medical student stood alone in the corner of the office, absorbing the chaotic scene that was part and parcel of everyday ward work. As he stared uncomprehendingly into the thick bundle of notes that belong to a Mrs X, he idly scratched at his stubble and thought about the wonders of modern shaving equipment and wondered, not for the first time, how long it would be ‘till sunset. It’s been a long day and the only thing prevalent in his mind at that point was the image of himself lounging in front of the television as he luxuriously slurps some hot soup which he will use to dip some hot garlic bread into. It’ll only take a few minutes to talk to this patient - a quickie, if you will – and he’ll be off without sparing another thought about her.

As is usually the case in life, intent and action rarely coincide.

The medical student flicks through the medical notes again, knowing that he was sent to see this patient for a reason. He slowly realizes that the hunger pangs that he was subconsciously complaining about were nowhere close to what this lady has been through. Breast cancer that has metastasized to her brains. Dementia. A history of multiple strokes that has resulted in a decrease of function of both her cognitive and motor aspects. This is a lady who has not only been through a lot, but doesn’t have much to look forward to either. A patient that some medical professionals would label as having ‘interesting signs’.

Walking to the cubicle that houses Mrs X, the student mentally prepares the list of questions and techniques of examination that might be useful during his (hopefully) brief chat with her. There is much that the books have to say on the subject of student-patient interaction, but almost of all of it is not germane to the issue at immediate hand. They bring their own physical mannerisms at fore, without fully considering the fact that for the species of Home sapiens, emotions and psychological considerations are of the most essential value.

There is nothing quite like a busy ward filled with really sick individuals. Stepping into a cubicle in this ward brings a variety of assault to the senses. The first thing that strikes you is the smell. An amalgamation of antiseptic, urine and human excrement. There is only so much that one can do when the patients are continuously incontinent. The most airy room or the most pungent Eau de Parfum would not be able to mask the smell that is strongly associated with sickness and death. The continuous moaning and chattering of the patients presents a cacophony of noise to the ears. The eyes need to get used to the various stares and vacant looks that greet them. And most importantly, the mind is set on Defcon 2, needing to steel itself against the mental assault that is bound to take place.

Sitting still in an armchair next to Mrs X (who was sleeping), was an elderly gentleman reading a magazine (for anglers) and sipping a mug of coffee. The medical student was conscious of this fact, and was hesitant to make a move. It’s not the first time, and it won’t be the last time that he wonders about the necessity of disturbing patients who otherwise would not be bothered. But as was pointed out by various patients before, he has to start somewhere. And there is no teacher who is quite in the same league as experience.

The old man stared suspiciously at the medical student as the student made his way to Mrs X’s bedside. Slowly and with a smile, the student introduced himself to the man that was Mr X. He explained that he wanted to ‘have a chat’ about her condition and to discover for himself the situation that she is currently in. The old man smiled encouragingly, pointing out that many students have come and gone, with varying degrees of success.

Gently waking Mrs X up, the old man explained to her the reasons behind the student’s visit. Mrs X stared at this man with vacant eyes, hands flexed in a gesture of pain, before she enquiringly said ‘Who are you?’ to the man that is her husband. Mr X smiled and waved away the question, squeezing her hand before settling back down in his chair to allow the student to talk to his wife.

Once upon a time, Mrs X was undoubtedly beautiful. Even at such an advanced stage of a terminal illness, she had a full lock of hair with strong, slender facial features. Cancer has an evil effect on people though. Her hair was thin, but nothing compared to the emaciated features of her body. Kate Moss would have looked at her and felt obese. She could hardly move, and the pain she was suffering was quite evident. This despite the fact that she was pumped with morphine, which contributed to her vacant, confused mental attributes.

There is not much point in going through the specifics of the student’s conversation with Mrs X. Hers was a cocktail of answers that never quite fit the questions that were asked. But it was during the course of this conversation that the student began to feel quite depressed. He tried his best to be empathic and imagine himself in Mrs X’s shoes, but he was aware of the fact that he would never be able to even begin to comprehend the complexity of her situation. Here was a lady, a mother of 3 children, who was once a teacher to primary school students. She volunteered at her local church, her passion was the choir. She’d go dancing with her husband on weekends, and their favourite activity was to picnic in the Lake District. An annual event that was looked forward to even before they were married.

That was 5 years ago. Now, she’s a shell of her former self. Unable to move. Unable to appreciate music, unable to appreciate the sun that basks on her face or the simple joy of another’s company. Unaware of her surroundings, unaware of the identity of the man that she shares her life with or the sons and daughter that were her pride and joy.

To suffer such a fate. The medical student can’t help but wonder about the injustice of it all. What had this lady done to deserve such an ending? She will not be leaving this world in a blaze of glory. She will be leaving it without remembering all the events that had made her life worth living.

Towards the end of the ‘conversation’, a ray of comprehension seemed to have driven itself through her haze of confusion. Suddenly, there were tears in Mrs X’s blue, empty eyes. She whimpered and stared at the medical student, looking around for a source of comfort. Immediately, her husband sprang out of his chair, arthritis and all; and took her in his big great, comforting arms. ‘It’s all right sweetheart, I’m here. Nothing is going to happen to you while I’m around here. It’s ok, darling.’ As Mrs X continued sobbing into his chest, the man that has been the rock in her life for the past 37 years gently stroked her hair and continued whispering sweet nothings into her ear. He smiled at the medical student, took his hand and said ‘It’s not your fault, lad. Don’t worry about it. She gets upset sometimes, but at least that shows me that she’s still in there somewhere’. Seeing his sad smile, the medical student mustered all the strength he had and smiled in return without truly expressing his feelings. He shook hands with the couple, politely excusing himself from the husband who was showering his sick, crying wife with all the love she needed. It was at this point that the medical student walked out of the cubicle, leaving behind one of the saddest and yet most romantic scenes he had ever come across.

I walked back to my room, quickening my pace. As I swallowed a huge lump in my throat, tears began to cloud my vision. Food was definitely the last thing on my mind.