by Jules Montague, The Guardian, 2 June 2015
Dr Montague, a consultant neurologist in London, explains why “it’s difficult to predict exactly when a patient is going to die, or, sometimes, if they are going to die at all.”
Why is it so difficult to prognosticate?
Every patient is different, every disorder is different, every disorder within a disorder is different. People are unpredictable, their illness even more so. But there exist other subtleties that are harder to admit to.
In my first week as an intern, I spoke to the family of an 85-year-old patient, Nora. She lay gasping, racked by sepsis, her skin bruised from intravenous drips, her legs swollen from heart failure, her consciousness clouded from all of it.
“How long has she got, doctor?”
“We’ll be lucky if she’s here in the morning,” I replied.
We were indeed lucky the next morning. We were also lucky for the next week and the month after that, at which point Nora went home, happy and healthy.
It takes experience to know that sometimes you don’t know.
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