He didn’t look too bad. He had lost weight from the time I had last seen him which was about six weeks ago. He was a bit slower to answer questions and he looked exhausted, but he didn’t look all that different. The lower leg ulcer looked worse, he had also developed a skin infection in his hip. He made it very clear to me that he did not want the infections to be treated. He did not want to go back into the hospital. He knew that untreated infection could lead to death. That’s what he wanted. He wanted to die as he felt he did not want to continue living after almost ten years of worsening pain. A decade of decreased function, of being unable to do the things he liked. He had been an active grandfather previously but he couldn’t do a lot of the things he loved to do with his grandchildren. Walking was difficult at times and he was worried about how his family were doing as he knew looking after him took a toll on them. He would never consider assisted dying but he wanted assistance from a higher power. He had been praying for his lord to take him.

We worked on his pain and brought it under control relatively quickly. Once his pain was controlled he felt better but he was still troubled by anxiety. We adjusted his medications and he was able to calm down. He became more active and started walking around our unit. He was still tired but he was in much better shape than when he had come in. We started making discharge plans. He and his family had found a residential care facility which they liked and we prepared to transfer him over. In the days before his transfer his pain got worse, a physical reflection of his distress at being moved was what we first thought. But then his condition worsened, and he became confused. We thought it was an overwhelming infection – sepsis – which had developed from a new skin infection in his abdomen. We cancelled his transfer plan as we thought he might die from his infection.

He proved himself to be stronger than anyone had thought, and a few days later he woke up again. We thought it might’ve been a temporary improvement as people may often have a last hurrah. A final gathering of energy and life force resulting in clarity and the ability to spend some quality time with family. It was more than that he was able to stabilise again, and in the next week, he started walking around our ward again. He became a bit bored and his family brought him in Lego sets to build. Little vehicles to start with. Soon there were cars, trucks, spaceships, boats, and buildings in his ever-increasing collection, he soon ran out of room on his shelf. He became well enough to go shopping at our Christmas Night Markets, his family wheeled him around in a chair.

Just before my vacation, I met him when he was walking down the corridor.

Hey, how you doing?

I’m good thanks. Still here.

I know you don’t want to be any longer, but it’s not up to us humans is it?

Yes.

He’s not ready for you yet, he must still need you to be on this planet.

Yeah. Oh well. We’ll keep on going. Anyway, you have a Merry Christmas.

You too, take care.