I thought I would have an unremarkable office day, returning phone calls, reading and replying to emails, drafting documents and generally moving some files along.
All that ended about 9:30 a.m. with a telephone call telling me that one of my clients had been found collapsed in his bedroom in an assisted-living residence on Dallas Road, that an ambulance had been called and that it was en route to Victoria General Hospital.
I thanked the caller, grabbed my client鈥檚 file, printed out a copy of his power of attorney and his representation agreement for health-care matters and drove to VGH.
I thought about our long professional journey together, how I had helped my client, his late spouse and many others deal with their first thorny legal issue: leaky condo litigation and remediation.
The remediation would be completed and the litigation settled. Afterward, both of them asked me to prepare wills and other planning documents. Too soon, I helped my client settle his spouse鈥檚 estate, later helped him come to terms with his grief and, then, his declining health.
For the sake of his privacy, I will just call my client L.
As I got to know him better, I came to understand that L was a true gentleman. He had been a project manager for a large company in Ontario and, after retiring, he and his spouse moved to sa国际传媒 to enjoy the milder winters.
A few years ago, following the death of his spouse, L had significant health issues. His sister from England called me, saying she could not get her brother on the phone.
After a few phone calls, I found L in the Royal Jubilee Hospital having suffered internal bleeding. He recovered and returned home.
After this, L realized he needed an advocate or representative to speak for him if he could not speak for himself. He asked me to act for him as his attorney and as his representative for health care matters.
As I arrived at VGH, it was raining. I searched for a place to park near the emergency department. I saw a father carrying his red-headed daughter with his spouse by his side, a look of anxiousness on both parents鈥� faces.
The emergency department was both quiet and noisy. Clerk receptionists were calmly taking information, children were crying and in the background, I could hear another ambulance approaching.
Within a few moments, I caught the eye of a clerk, explained who I was, why I was there, and who I represented. Within seconds, I was whisked to a large treatment room.
The room was empty except for a paramedic who had responded to the 911 call to help L. The paramedic told me that L was off getting tests and that the nurses and a doctor would be returning with L shortly.
The room did not look like Seattle Grace or ER. It was an orderly mess, with things here and there, with a cleaner attempting to bring order to what must have been an intensive examination of L.
As I stood at the side of the room, a nurse approached me and asked who I was. I explained that I was L鈥檚 representative and lawyer. I provided the nurse with a copy of L鈥檚 representation agreement.
The nurse calmly explained to me that L was very, very ill. Then a doctor came into the room and said he was the doctor who had first assessed L. After I told him him that I was L鈥檚 representative, the doctor explained that L had suffered a massive brain bleed and would be returning to this treatment room shortly.
The doctor asked me if I wanted to view the 鈥渇ilm鈥� of L鈥檚 brain injury. He warned me that the film would be dramatic 鈥� and it was. It showed the outline of L鈥檚 brain cavity and a large white area that the doctor quickly told me should not be there. The brain bleed was massive. He told me that even a much-younger patient would not survive it.
The doctor and I returned to the treatment room. Soon L was wheeled in, accompanied by about six nurses, each doing something for L. All the nurses were carrying out different functions in unison, like a well-rehearsed chamber orchestra, but without a conductor.
The nurses spoke gently to L, saying that the tube down his throat was going to be removed.
The doctor told me that L was not conscious and more likely than not had no brain activity. The doctor said he had ordered that L receive hydromorphine to keep him comfortable. After the tube was removed, the nurses withdrew and I was left alone with L, pending his move to a private room in the emergency department. I was told that I could stay with him, both in the treatment room and later in the private room.
A social worker approached me and asked me how I was. She seemed genuinely concerned for me. She asked me if I had seen someone die before, and I said I had. She told me that sometimes the end of life was not pretty and that I should not feel obligated to stay.
Within a couple of minutes, L was moved to the private room. Within a few minutes, a nurse popped in and asked me how I was doing.
This nurse asked if I wanted coffee, tea, juice or water. Again, this nurse spoke quietly and was most gentle and considerate of me. This nurse also asked me if I had witnessed someone dying and when I told her I had, she explained that L might struggle to breathe for the next little while, but that she could not say how long he would live.
If you did not know better, you might have thought that L was sleeping, at times snoring gently.
At about 11:15 a.m., the owners of the assisted-living residence arrived and I briefed them about L鈥檚 condition. I left the room so that they could have some quiet time with him. In about 20 minutes, I returned and suggested that they might want to return to the assisted-living residence to help prepare lunch for the other residents.
For the next four hours, at about 20-minute intervals, various nurses or doctors came into the room to see how I was doing or to monitor L, or to give him another injection. Each time, the nurse or nursing student would explain to me what they were about to do. Each spoke to L as if he could hear them. Each spoke with gentle affection. Each respected his dignity.
At the end of the day shift, another doctor came in to see me, explained that he was in charge of L鈥檚 overall care, said that he could not predict how long L would continue to live. Again, this doctor asked how I was doing and if I needed anything.
I reassured him I was fine and that he should go and assist others. There was nothing he needed to do for me. I thanked the doctor for the way L was being cared for: gently and very regularly by a variety of nurses or nursing students. The doctor asked me if I wanted a coffee, tea, juice, water or some food. I asked if there was a charging station for my cellphone, since my battery was now spent. He explained with a sigh that there were no charging stations.
As L lay in his bed, he gently snored. As the afternoon progressed, his breathing became more laboured. At about 4 p.m., there was silence. I waited a couple of minutes, checked for a pulse, and then went into the hall and called for help. A nurse and a nursing student both came into the room. The nurse checked L鈥檚 pulse and found none. The nurse then covered L鈥檚 face. L鈥檚 life鈥檚 journey had ended.
Almost immediately, the nurse and nursing student asked me if they could do anything for me. The supervising nurse came to meet with me, explained that the coroner would likely be called, given that L had died in the emergency room.
This nurse asked me if there was anything she could do for me or if there was someone she could call for me. She, too, like all the other professionals, treated L with great gentleness and with dignity. This nurse encouraged me to stay with L鈥檚 body for as long as I wanted. I was told that there was no hurry for me to leave the room and that I should take my time. I collected myself, washed my face and hands and left.
Before leaving, I approached the nurse and doctor desk area in the centre of the emergency department, cluttered with papers, monitors and files. I thanked those who had so lovingly cared for L during the final seven hours of his life.
Don鈥檛 let anyone tell you that doctors and nurses and paramedics are insensitive. From my close observation of L鈥檚 care, everyone did their work efficiently, effectively and with dignity and kindness, both toward each other, but more importantly, with L. So, too, did the technicians, the cleaners and the front-line receptionists, all at times under the strain of crying children and anxious parents or other patients.
I have a greater respect and appreciation for all the emergency-room staff and their support team.
By the way, the little redheaded girl and her parents got to go home, in the rain.
Also by the way, the emergency room now has a five-port cellphone charger with retractable charging cords for Android and iPhones, compliments of L鈥檚 estate.
R.C. (Tino) Di Bella is a lawyer in Victoria.
