Who knows what today will bring

In bay 1, a man has fallen 8 feet from a ladder. He’s in severe pain every time he breathes, having fractured all 12 of his ribs.

In bay 2, a man was just brought in by ambulance, having been found unconscious from the fumes of a fire in his own home. His 13-year-old son, who managed to get out relatively physically unharmed, is currently being looked after in the paediatric hospital next door.

In bay 3, a lady who fell on her wrist and fractured it, is being given ketamine for sedation while it is put back in place. Before the ketamine kicks in, she tells me that she is worried about her 9-year-old son, who is autistic, and how he will cope staying at his Granny’s house tonight - since that is different form his normal routine. When the sedative begins to take action, she tells me about how much she loves bubbles.

In bay 4, a lady has come in with cardiac arrest. Her veins are injected with adrenaline, tubes placed in her airway and her lungs pumped with a bag. She has blood being taken from a bone in her leg, a vein in her groin, and an artery in her neck. Machines beeping, staff rushing, and all the while she remains completely unaware. Her pupils are fixed and dilated, her skin is mottled and stone cold - we know she is not going to live. And yet earlier today, she went to the dentist, sat in her living room with her family as she ate dinner and watched her favourite TV programme. Investigations keep being rolled out, first she’s wheeled to a CT scanner, then an X-ray, all the while her bodily functions are barely maintained by a string of machines.
A friendly anaesthetist asks while waiting for the X-ray, if I have any questions. He means in regards to the drugs administered, but my question is how do you know when to stop? How do you know when you are prolonging life, and when you are prolonging death?
It’s an easy question to ask when we are with this lady - whom we’ve only known in this deteriorating, yet peaceful state. It’s a harder question to ask when you are sitting with her husband and 3 daughters, who were not ready to say goodbye. The more I learn, and the more I see...the less I know, the less certain I am - about what is right or wrong, better or worse, what should or should not be done.