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Even when you can’t do much medicine, you can still do a lot

Tucked away in a quiet corner, behind the headline news of the nation’s soaring complaint figures, there are still patients who appreciate what we do. Some of them are astonishingly appreciative.

Mrs E has a pretty bad prognosis. It’s metastatic, and the surgeons can’t offer anything more. I’ve tried to admit her a couple of times, when there’s been a particularly long interval between pressing the call bell and hearing her familiar cough coming down the corridor.  But she’s having none of it.

And so we sit for a while and chat about life, and about death, and I do what I can for her symptoms. A couple of weeks ago she asked me if I’d ever really thought about what it would be like, to really know you’re dying. She’d never thought she would have the time to appreciate death’s approach, to feel it growing inside. She decided it might be useful if she wrote down her thoughts, knowing that it wasn’t an abstract, that it really would happen – and perhaps soon.

Last week, she gave me her 400 words. The worst time, she says, is the weekend. Nothing happens at the weekend – no letters from the hospital, and no chance of hearing a decision on palliative treatment. Just a waste of days, dragged unwillingly from a dwindling stock.

She happened to give me her writing on a Wednesday.

On Thursday, we heard the final decision that surgery wasn’t going to be an option. I had read her words about the desolation and loneliness of weekends.

And so, after finishing clinic on Friday evening, I thought I’d better give her a call, and make sure she was OK and wouldn’t be on her own over the weekend.

It’s all a bit embarrassing. The call cost me literally nothing, and it was 10 minutes at most. But from her reaction, and the way she’s described it to friends and relatives, you would think I’d reached in and pulled out the cancer. She spent the weekend making embroidery for me. Once again, it’s a reminder that when you can’t do much medicine, you can still do a lot.

Dr Nick Ramscar is a GP in Bracknell, Berkshire