My first encounter - Shared case

I hesitated and pondered whether I should post this story. Since it is a story, kindly just take it as a story.

This Case belonged to another volunteer. Due to her family travel plan, she had to leave for two weeks holidays. I was in the office and Matron asked whether I am able to take on temporarily.

Taking over the case file, I studied the record. This was a family of four. Consisting of Father, Mother and two kids - both were boys of 7 and 10 years old. The patient was the Mother. She had breast cancer and it had spread to other parts of the body. She underwent chemo which was very costly for her family to bear. The man of the family worked as a delivery man in a logistic company. The two children were in school. The volunteer following this case had been with them for 8 months now.

Lian : OK, I will take the case so that Maggie can take a break.

I visited the family. It was a neighborhood in the East. It is a 4-room HDB flat.

Boy : Ma!..someone from hospital to see you. (He shouted and opened the gate. I believed he was the elder boy. Too small built for a 10 year old. He looked like he just returned from school as he had uniform on.)

Lian : Thank you.

My usual habits - I scanned the house. There was a 20" TV in the living room and a simple sofa set. The boy was doing his homework on the dinning table. The house was clean and neat. Clothes hanged on the cloth lines inside the kitchen area of the flat.

Gina : Hi, you must be Lian. Matron called yesterday that you will come today. Thank you for the trouble. (I saw a lady lying on the bed. She lost lots of body mass and she looked like a skeleton. When she spoke, her voice was shaky. I took a quick look around the room and to my surprise, the room was clean and neat too.)

Lian : Thanks Gina. Maggie is on holiday so I am standing in for her. She sends her regards. How are you today?

Boy : Aunt Maggie said she will buy presents for me and Jack. (He smiled happily. Kids are kids, even adults love a present, don't we? I smiled and nod my head.)

Gina : I am having a lot of pain today. This is my boy Jeff, he is the eldest and Jack is his younger brother and he is in school now.

Lian : Oh I see, where is your husband?

Gina : He had to go back to work. The company called today that they have goods to send out. He is actually on leave but they are shorthanded. We feel very bad because Teck has been taking leave since I am sick. He had to look after me, the children and do all the housework. (So I see. The cleanliness and neatness of the house is the Man who did the job. It must have been tough for him. Not that Man do not do housework...but I know many left it to their mothers, wives, sisters, maids, girl friends...etc. They will do a little if they have no choice. I looked forward to meet this Man.)

Lian : Is there anything I can do for you? Did you eat something today? You want me to cook something for you?

Gina : No, I have no appetite. Can you pass me the panadol and some water? The pain is bad. Teck left early today and did not clean my wound - you think you can do it? All the medicine and items are on that table.

I handed her panadol and water. Doctors sometime advice patients to take panadol as a pain killer. If the pain is worst, they will administer morphine. Yes, morphine as in the drug Morphine...it is a pain killer and a very strong one. I went over to the table and saw gauze, cotton, saline water, some cream, scissor, bandage, plasters etc. I gathered them and went over to the bed.

Lian : I learn some First Aid, may not be as gentle as your husband. So if I apply to much pressure, please tell me.

I slowly took off the bandage, the gauze and I saw the wound. Deep in my heart the first thing that appeared was 'Oh My God'. The wound was the breast. I believed she had mastectomy and the wound did not close. Now she lost so much body mass, I could see the whiteness of the bone. It must be very painful. I took some warm water, pour some antiseptic lotion and with cotton, I slowly clean the wound. It smelled...but I can bear it. Breast to a woman signifies womanhood and motherhood, let alone the aesthetic aspect of it.

She did not make any sound of discomfort. I tried to be as gentle as I can. I wrapped up the dirty materials, applied clean gauze and plaster and bandage the wound. I laid her on the bed. She closed her eyes and probably was exhausted. With such 'killer' and the energy level, simple thing that we do or lift is an extra burden to her. I took the dirty water and materials to the washroom. I threw them away, washed up my hands and came back to the room. She was sleeping? I walked back to the kitchen, rearranged the clothes on the bamboo and put them out to sun. I went to the living room. This time Jeff was watching TV.

Lian : Jeff, did you finished your homework? Do you need me to help you? Did you take your lunch?

(Aiya! why do I keep asking questions when I came into this house. I was concerned but I found myself long-winded! Sometime concerns are seen as interfering..and meddling..and instead of being appreciated..people think you talk too much. I always say what I feel..and I don't say it 'gently'...because I ask direct questions and expect direct answers. Jeff was curious about me so we talked. He asked about my work, where I live, how I got to his house, will I go fetch his brother from school with him because Dad does it but today he will be late. “Of course” was my answer.

Lian : Jeff, how are you and your brother taking Mother’s sickness?

Jeff : Mother used to send us to school and picked us from school. She gave us tuition. Mum is a good cook you know. When she is better, you should ask her to cook Laksa, taste very nice and better than hawker center. We don't know how sick is Mother. Starting, she and Dad cried a lot but now better. Dad used to take us swimming or to MacDonald but now he got no time and no money. He said money must use for Mother's medicine so she can get well.

My heart bleeds. Young boys, they knew that their parents were in difficulties. They knew Mother was sick but how sick? Not for me to tell him. He missed all the family outings and at his tender age, he tried to understand. It puzzled both of them why their parents were crying. They have bare minimum...I opened the freezer, nothing much inside. No chocolate bars, no butter or jam, no coke, just some left over dishes and some vegetables. To those out there...that has everything...half eaten food and throw them away...keep changing new toys, new everything...they will never know and appreciate 'difficulties'. I said before, Hospice makes me a better person. I learn how to love people…other than my own people. I learn to give...unselfishly within my capacity.

I went with Jeff to pick up Jack. Jack is 7 years old and still too young to know anything. He was chirpy and happy. I bought them ice creams. On the way back I asked them what they wanted for dinner. They were hesitant at first but I said it was OK. So both have chicken drumsticks and rice and both wanted a can of Coke.

I went in to check on Gina again. Cooked her some porridge and she can only managed two spoonfuls. The medicine and all the chemo probably have numbed the taste buds. I stayed to give her medicine. I do not want to leave her and the children alone until the husband is back. Looking at my watch, it was half pass ten at night and he was not home yet.

I finally saw Teck. He looked exhausted from the day's works. He went into the room and talked to Gina. He held her hands and listened to what she told him. He turned back and smiled at me and thanked me. He asked the two boys about school works and told them to leave their soiled school uniforms in the pail so that he will soak it tonight and wash it before he goes to work the next day. Jeff told him I bought them dinner and his dinner of roast pork is on the dining table. Again he said 'thank you' and he went to shower and ate his rice silently. He was a man of few words. It was my first day so I did not really had a conversation with him. Moreover he looked troubled, tired and deep in thoughts. I took my leave.

The next time I went back was four days later. I bought MacDonald for the boys. I hope to make up for what they missed...but I think it is more the family togetherness.

Maggie bought big boxes of chocolate for Jeff and Jack and she bought each of them a nice school bags. I saw the joy on their faces. My visit with Maggie was to have a proper closure and informed the family that I handed back the case to Maggie. It is rude to just disappeared without saying goodbye.

After that I was busy with work and my own Case. I did not see Maggie until we had our Monthly Support Session. We were sharing our cases...and when it came to Maggie..there was a long..long pause.

Doctor : I want to talk to you all about Palliative care. You all have been doing very well. Palliative care does not stop when patient died. We will have to follow the families for a little longer to give them support and I know some of you continue to see families. You all did the right thing. Tonight Maggie has something to share with you.

Maggie : My patient Gina, passed away two weeks ago. Lian supported her when I was on holiday. (Maggie broke down and cried. We allowed her to cry. I was crying myself...because I was also connected to Gina.)

Maggie : I went back 7 days ago. I saw Teck. He was very down. The company dismissed him because he took too many leaves within that one year to attend to his wife. He mentioned that now that he lost his job, he will not be able to pay back the debts owe to relatives and parents. He will not be able to pay back the funeral services. (Maggie paused and cried harder and she finally said...)

Maggie : Doctor had a call this morning from Teck's family and we rushed to the house. Teck committed suicide! He jumped down from their 10-storey flat in front of the two boys....He left a note saying that Gina was his motivation to live. As long as she lives, no matter how hard life was, he can bear it. Now that she is gone...there are no more reasons for him to go on. No one understands him. He had lost his job and he will not have the means to take care of the two boys. He asked that his younger brother and sister-in-law to take in the boys and love them like their own after all they have always love Jeff and Jack.

We were all crying...my heart broke....my thoughts went to the two boys...how are they taking it...how are they going to go on in life...will it be a stigma on their growing up?...Thoughts ran through my mind....endless thoughts.)

Till Death Do Us Part...a vow the married took....Is this what it means? I am in no position to comment. Is he right? Is he wrong? Who can censor him? We are not in his shoes.