I understand well when the patient is calling for a ‘taxi for mercy’

What qualifies me to do the work? I believe in the nobility of man and that ordinary patients will be less ordinary by the time of their discharge.

I believe that the human mind is immense.

Staying sane despite disability and disease is a matter of stoicism (bloody mindedness) for some. For others it is an intellectual or spiritual challenge. It is for me to speak to those facts. And I tell 97% of the funnies on any ward I work on which smooths my passage around the hospital.

Both my father and grandfather lived short lives with disability. And since then suffering has dogged me everywhere. Suffering is my terrible twin. In my forties with health issues of my own I decided that understanding suffering might be the path the universe intended for me. I’m just one individual but what does mankind as a whole know about suffering? For 20 years I read anything and everything about human suffering.

The great tragedy is that 90% of human suffering is caused by man himself. Most suffering is man made, therefore unnecessary.

The NHS is an institution that has a mission to reverse suffering. In my first five years I have engaged over 12,000 patients. I have engaged patients who have had quadruple heart bypasses, new hearts, new livers, stem cell therapy, TB and Monkeypox.

I have engaged over 1,000 patients in Covid isolation (my Steve McQueen patients). I have engaged a one-legged patient who has survived six strokes. A patient who has survived six heart attacks and a patient who survived kidnapping.

Some of our patients are deeply inspiring characters. Another patient lost four relatives in one afternoon. Sometimes I can do no more than listen because there is nothing useful to be said.

Major bouts of illnesses and disease would own us, take us over. What we all might seek is that our illness does not define us. The first thing that people say about us reveals much. That’s so and so, he’s got cancer, not good. That’s so and so, he’s just bought a 1,000cc motorcycle and he has cancer, much better.

If the illness or disease is overwhelming (we have patients trying to stay sane by the hour), then we need to fight for the small victories, sometimes that’s all there is. Patients in difficult circumstances fixate on small achievable victories when the bigger facts of their existence seem beyond them.

12,000 is a very good sample size, a treasure trove of sorts. It’s amazing what patients can cope with as long as there is a little hope of improvement.

We don’t like chemotherapy but we accept it as a lesser evil. We don’t like chronic pain but somehow we know that pain is the price we pay for the privilege of growing old.

We really don’t like taking 60 or 70 prescription meds a day but many patients do. We hate wearing nappies. We didn’t like it the first time around but most elderly patients wear nappies. We do not like being unable to wash ourselves. We hate with a passion continually having to ask for help. We do not like being fed with a tube through our nose into our stomachs. We hate the indignity of having a bag.

However, life is the greatest prize of all and we can suffer and endure many things as long as there is a little hope of improvement. But when any hope of improvement is gone what is there?

A percentage of patients will think any life is better than no life. We fully honour and respect that choice. But these are usually people with money enough to cover the shortfalls in their ongoing care.

For the remainder. Being aged, sick and to a large degree helpless is terrifying. It’s not a life, it’s an existence in purgatory, they claim. And they know the demands of looking after them will mainly fall to their elderly partner. Posing a very real risk to the health of their partner.

It is perhaps the greatest expression of unconditional love to look after a helpless partner at the end of life. But it is not easy. A percentage of patients at this point will see no profit in life and wish for an end to their suffering.

The NHS is a temple of healing where we never use the term euthanasia. It’s never discussed. But I understand well when the patient is effectively calling for a ‘taxi for mercy’.

ANDREW LE PAGE

Glenholt

Devon