The Frayed Bandage

    Now and again, I’ll have a patient in my A&E who is suffering from a respiratory disease of some kind, and they are experiencing “air hunger.” This means that their breathing efforts, while laboured and strained, are not resulting in enough oxygen entering their body. It appears exhausting, but it also looks frightening. I often see fear, sometimes terror, in their eyes as I do what I can to help their breathing. While I have always empathised, I had never experienced such breathlessness myself. Until March 2020. Along with fever, aching muscles and profound lethargy, that Spring morning introduced me to the feeling of air hunger. I sensed a rising fear within that I couldn’t “get enough air” despite working hard. I needed to send a text message about an appointment I was not going to make, but I couldn’t focus on the screen, and the phone fell from my hand. I spent the rest of the day barely moving in bed, trying to suppress a black fear that felt close by. I had,...

  “What’s your understanding of what is happening with your health right now?” I asked my patient who had come into A&E feeling quite breathless. I knew something of the context here: the man had advanced cancer and was probably experiencing a complication caused by further spread of the disease. “Oh, you know, I’m just getting on with it as best I can” he replied, adding that “the specialist is reviewing things in a few months’ time I think, and said they will repeat my CT scan then”. This caused me some alarm. You see, my understanding of the situation, having read the patient’s medical file, was that he was in the last weeks of his life. His most recent CT scan, done after a rapid deterioration in his condition, showed significant disease progression involving spread to several organs including his heart. So why had the specialist doctor offered to review the patient in 6 months’ time when life expectancy here could be measured in weeks? And why did the patient not know this...