A commotion at the end of the corridor made us all curious. Me, trying to be cautious, waited at the other end of the corridor to hear what was happening from others who had ran towards the commotion. Little did I know it involved someone I knew.
Lewis, 11, had complained to his mother of pain in his leg some months earlier. Tickled by his captive imagination to get himself out of chores and homework, she had given him a ‘paracetamol’, a glass of milk and told him to stop the rough football he played with his friends and just sleep it off.
However, after a few more leg pains, mother and son agreed that they would go see the doctor as soon as the approaching school holidays came. She was surprised that he agreed to a doctors’ visit as he did not like doctors, hospitals nor injections.
Over the next weekend, after a chat with her husband who was a nurse with MSF on a foreign mission, and just as she was settling in to have a cup of tea, she heard the desperate knocking from the neighbourhood kids screaming “Mama Lewis, Mama Lewis, he has fallen, he has broken his leg, he is crying...”
She ran to the playground to find Lewis down on the ground, with his leg twisted in an abnormal angle, crying, screaming and writhing in pain. Luckily, a neighbour who was a medic had also heard the commotion and come out to see what was going on. Together, they secured his leg, called an ambulance and were taken to the Accident and Emergency (A&E) unit of a nearby hospital. That was the beginning...
An othopaedic doctor reviewed Lewis, studied the x-rays and ordered more tests. He asked that Lewis ‘s parents come back the next day at 11am to discuss the results of the x-rays and other tests.
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Nervous and worried Mama Lewis was at the hospital by 9am. She had had a long conversation with her husband the night before and did not like the prolonged silences in his responses when she told him of the tests ordered. She did not like the fact that her husband had told her he would try and make it back home as soon as possible.
The diagnosis on Lewis – could possibly be an infection like tuberculosis or a cancer, most likely a sarcoma on the leg both were treatable once the diagnosis was confirmed. Lewis urgently needed a biopsy to confirm the suspicion.
Mama Lewis did not take the news well, shocked, wailing and hysterical, she insisted that the doctor got it wrong.
The uncle decided to take her out of the room for a few minutes. The aunt stayed. She informed us that she was a nurse and her brother, Lewis’s father, was also a nurse and would be home soon.
She thought it should be possible to start treatment, but meanwhile we sat and waited for Mama Lewis to return. Twenty minutes later, Mama Lewis and her brother came back to the office.
Remarkably calm, she asked us to explain the way forward. Later, she asked for other options, demanded to know where we went to school and who gave us the right to think such things of her son. Finally, the meeting ended with no clear way forward. We had hoped that by the time Lewis’s dad got back and they discussed the situation as a family, or after she had had a chance to come to grips with the reality in front of her, she would relent and agree with our assessment and treatment plan.
She didn’t. In the end she left with her son.
Months later, we were surprised to see young Lewis back in hospital. I was called to counsel him and his family. Weak and breathless most of the time, he had a very worrying request to me.
He wanted his mother to stay away from him, he blamed her for the lack of active management from our side. His father had tried everything possible to get Lewis treated but his mother completely refused. Apart from keeping him comfortable, we needed to try and mend the boy’s relationship with his mother. Lewis’s extended family regularly came to see him, supporting Mama Lewis as much as they could.
The palliative team also needed to broach the subject of Do not resuscitate (DNR) for Lewis should he end up in the ICU. Two weeks later, Lewis was at the ICU. His mother monitored the helpless situation until her son breathed his last. She had reconciled with her son at the end.
“She wants to jump, pull her back,” we distinctly heard those at the other end of the corridor saying.
As we approached, we saw that a woman was hanging over the side of a first-floor walkway, with people holding onto her legs.
- An anaesthetist and palliative care doctor, specialising in total pain management, tells of her experiences with patients and their families.