One of the cruellest consequences of COVID lockdowns was the restriction that we had to place on visitor numbers. We were generous in that we would allow each of our patients up to four named visitors, but this still fell short when it came to families with more than four members. We acted with humanity and compassion, thinking to ourselves how would we feel if it was us in their situation? But what do you do when someone has 15 children? It is difficult for a family to choose who gets to come in, and who has to stay out. Video chat technology allowed for virtual visits but they were no replacement for in-person visits.

Our patient was a man in his 50s who had six children, the two eldest lived out of town. The four younger children were keen to spend time with their Dad, and their Mum struggled to choose who would be the nominated ones for any given day. The family had always been close and the parents had home-schooled their children. They had always done things in their way. Having Dad critically unwell and away from home added to the overall disruption of their family life. Our team’s opinion was that our patient only had limited time left to live. Given the circumstances, we flexed our approach and allowed the four younger children to visit alongside their mother.

This allowed them to spend time with Dad as he faded before their eyes. The family had always been self-contained and had been practical in their approach to life. As part of their homeschooling, the children had been taught practical skills such as woodwork. Money was tight and they needed to save as much as possible. The family had made funeral arrangements that would not involve a professional funeral director. They completed all the relevant paperwork to comply with local laws. They had requested a cremation at the local crematorium which would occur soon after death.

After Dad’s death, the eldest child arrived with older members of their extended family. They had built the coffin themselves which was brought into our ambulance bay. I helped the other adults lift the patient’s body down into the coffin. The eldest child then lined up the lid with the coffin edges. An electric screwdriver appeared and then the lid was screwed in place. We helped to carry the coffin into the family van and then the family all headed off for their private funeral service.

He had always lived a bespoke life, and it was appropriate the did things his way after death too.