Some of the patients we pick up are going to die. Soon. Most of them know this, especially if they are coherent enough to have any idea what is going on. Today was a different type of experience. Instead of picking up the patient from the hospital or nursing home, we picked him up from a personal residence and he had no idea what was going on.
He was lying on a bed, with his rear on the pillows, his head pointed toward the foot, and his feet propped up on the portable commode. The tension in the house was nearly visible, with three men looking quite upset and one woman fussing around. The woman was really the only one who wanted to talk, and she just kept stressing "We just can't take care of him anymore", as though we were going to take one look at her and leave the patient there. She had a reason for everything, even though nobody asked.
When the patient saw us, he looked confused and spoke in French to the woman who told him something in return. She looked at us and confided that he doesn't know he's going with us. We told him he was going for a ride in the ambulance, his answer was "why?" D explained that his family needed help taking care of him, he responded "am I going to die?" We immediately looked to the family - who had all fled the room. We followed them out and it turns out that the patient was aware he had cancer, but apparently nobody told him that he was going to die soon, and one of them pointedly looked at D and said "you tell him."
We tried to argue that this was more appropriate to come from them, but no luck. With the collective guilt in the room, you might've thought they were sacrificing small children in the basement instead of asking for help caring for a very ill family member. Very weird all the way around. But quite frankly, with those folks, I think he's better off at the extremely nice hospice house we took him too.