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The acute care conveyor belt: a personal experience

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This wasn’t “end of life”; this was his life.

Perhaps the best comment I read at the time of the big 2015 bacon scare was “So what are we allowed to die of?”. Every stage of life has now become medicalised, not just birth and death. The fact that there is even a conveniently euphemistic acronym for the end of life, “EOL”, rather than the words themselves, is symptomatic of how removed we are as a profession from the reality that despite our very best efforts, life has only one ultimate outcome. But Hillman and colleagues’ description of the “acute care conveyor belt”1 eloquently describes the path that I impotently watched my father travel.

At 86, he was extremely well — still golfing and travelling, dining out and never missing the latest films. There was the usual raft of preventive medications to control his sugar and lipid levels, his gastric acid and his blood pressure. There was even an indolent carcinoma that created some inconvenient symptoms requiring increasingly regular trips to hospital for antibiotics and a first-name relationship with the local ambos.

This wasn’t “end of life”. This was his life — each day just like every day before presenting its own unique challenges and pleasures. That he would die sometime in the next while, he knew and accepted. What mattered…