> Apology accepted Stooge.

Good :) although it would appear I wasn't the only one who misunderstood.  What did you mean?

There is little wonder he doesn't value his life, he cannot do anything for himself, he is paralysed from the neck down. He is of sound mind and if he judges his own life to be one of unimaginable suffering, suffering that is so bad that he wants to die, then that is good enough for me!

It should be his choice, not yours or that of anyone else, who chooses to adopt the moral high ground.

Each case should be judged on an individual basis as I have already stated. I am not saying I want the law changed so that anyone can assist the killing of another terminally ill or severely disabled person. Careful measures have to be put in place to ensure there is no room for such a law to be abused.

Quality of life is everything... simply being alive is not always enough.

No Stooge I dont believe anyone else misunderstood.

I don't think seeing the potential around disability is taking the moral high ground :)
As I say, it amazes me that people can work in that area and not see that but then I believe most medical professionals do.

> No Stooge I dont believe anybody else misunderstood.

What did you mean then?

'Simply being alive is not always enough'.....point well made.

> No, it is about him and everyone like him

I disagree - it is about HIM alone.

I have tremendous sympathy with him and anyone else in a similar position, but I do feel that any changes to the law must not be rushed. It would be too easy, as has been shown here, to make the individual feel that they are a burden on their family by staying alive or equally that their family has too much influence on the decision.

> It would be too easy, as has been shown here, to make the individual feel that they are a burden on their family by staying alive or equally that their family has too much influence on the decision.

That is what I mean by everyone like him.  

> That is what I mean by everyone like him

But everyone is an individual and until someone is put in that position they don't/can't know what it is like nor how they will cope - so others making a decision on their behalf is presumptuous surely. You and I know nothing about what his life is like. But, I still think that due safeguards must be put in place before allowing someone the right to choose to die and expect a professional to carry it out.

I haven't read all the posts, during my 40 yrs nursing I have come on duty to patients and relatives being really distraught due to terminal pain or gasping for every breath, many nurses were scared to give the prescribed medication for fear of getting into trouble if the patient died quicker than expected.

The worst case I ever encountered was a 52 yr old woman with a growth in her neck which was pressing on her trachea and the blood vessels in her neck making it hard to breath and her face was purple with congested blood, when I went in to check on her having been told by the evening shift that she was comfortable I was horrified at what I saw, she had 3 teenage children and her hubby in the sideroom with her, she was sitting up in bed gripping the edge of the mattress and struggling for every breath and her family were sobbing standing away from the patient, I told them I would get things sorted and the patient mouthed  Thankyou" to me.

I checked her medication and contacted a Dr to come an increase the dose of meds in her pump, to get enough Diamorphine I was going to have to get in the On Call Pharmacist as there wasn't enough in the 4 wards on that floor, I contacted the Nursing Night Manager for advice and he suggested the Dr gave her an IM injection and see if it with the pump was enough to get things under control, we checked out the Diamorphine, not a huge dose and asked the family to wait outside, the injection was given and the family came back in, her breathing became easier, the family stopped crying and sat around the bed holding her hands and talking quietly, I left them and popped back every 5 mins or so, 20 mins after the injection she passed away, the final memory the family had was her settled and calm, not what I had witnessed earlier.

I rang the Dr to let her know the patient had passed away, she went hysterical shouting at me that she had killed the patient, I told her to come up to the ward and see how things were then compared to when she gave the injection, she reluctantly did and spoke to the family and saw the change in them and Thanked me for making her rethink things.

I rang the Night Manager and reported her passing, tongue in cheek he asked me if I was practicing euthanasia, he didn't expect an answer, this experience was back in the mid 80's and helped me no end during the 20+ yrs I continued nursing.

It is the fear of retribution that stops medical staff from prescribing/giving medication to keep the patients comfortable and let them die with dignity. There are plans of care now for the dying with guidelines as to what to give for each symptom and Drs are more ready to follow them as they know that they have been layed out by a team experienced in the care of the dying.

I think patients with terminal conditions should make "living wills" when they are well enough mentally and physically to make those decisions.

"I don't think seeing the potential around disability is taking the moral high ground"

Stooge, exactly what potential does a person with locked in syndrome whose life is so blighted by his condition that he wants to die, actually have?
Your views are idealistic.

"It is the fear of retribution that stops medical staff from prescribing/giving medication to keep the patients comfortable and let them die with dignity".

Indeed.

Why if the medication is prescribed in the guidelines then what is the problem ? This is palitive care we are talking about which again is a subject that needs discussing and changes made.

">Each case should be judged on an individual basis as I have already stated. I am not saying I want the law changed so that anyone can assist the killing of another terminally ill or severely disabled person. Careful measures have to be put in place to ensure there is no room for such a law to be abused.

I agree that each case should be looked at individually and I do feel that this poor man is suffering possibly more than he feels he is able to endure.

I think the problem for him is not that he needs assistance to kill himself he actually needs somebody to kill him as he totally unable to do it. He wants to have the right to have his life ended when he feels good and ready and for the person who would have to be from the medical profession not to be charged with murder fo doing so.

That's where the problem lies.

>It is simply that communication is communication and this man has it.

And he has communicated his wish to die. He's an adult of sound mind, yet he's being treated like a non-sentient baby. What's the point of communication if you're ignored?

Frequency of doses is not always made clear, it could say " for symptom control", this is fine for those of us who have been caring for the dying for decades but the newly qualified Drs/Nurses don't have this knowledge and many won't ask for fear of being thought as ignorant or they think they know it all and don't need to ask, I was still querying things up to last year when I retired.

Not all drugs work on all patients, you need to ask about alternatives not wait till the Paliative Care nurse comes around the next day.

Isn't that why that brought in nurse practitioners to bridge a gap ?

I think JG's comment about his communication is bring ignored is so relevant.

Well said JG!

One thing that concerns me, given the ruling, is his intention to starve himself if necessary - how will he do that, without his family or carers being considered responsible as they are caring completely for him?  It worries me that even that option might not be one he can exercise for fear of what happens to them after he's gone.

    >It is simply that communication is communication and this man has it.

And he has communicated his wish to die. He's an adult of sound mind, yet he's being treated like a non-sentient baby. What's the point of communication if you're ignored?

You are so right JG, this is what terrifies me the most of one day leaving behind my beautiful daughter who has ASD knowing full well that because she struggles to communicate that her basic wishes will not be fulfiled. There are far to many do gooders in this world that do more wrong than good and just inflict misery on others purely because they think only their opinions count ;(

This man knows the outcome of the choice he wants to make but because others are so frightened of death he is being forced to endure, can you imagine you have a itch on your nose and your hands were tied or you just thought of something funny but it takes you 10 minutes to blink out what it was by which point youv forgotten or you just fancy listening to your favourite song but you have to wait for someone else to go fetch it for you. Honestly he is of sound mind he wants to choose bloody hell let the man have some dignity and go on into the oblivion that one day he will be apart of anyway.

> I wonder if they can't get him to Switzerland?

I have always believed that this would be my own personal choice, so nobody else would need to feel any guilt, as not actually involved in helping me.

However, after making Dignitas enquiries, I find it isn't as easy as just travelling to Switzerland.  I don't have £10,000 in savings to pay for my own euthanasia.

Just tagging on at the end here,

There is that other side where people basically become depressed and it is depression which is driving them not to wish to live, look at all the needless suicides that happen every year because someone is on a down at that time, the following year they could have been laughing and loving life.

I watched my friends mother who had emphysema withdraw from life, years before it even got bad, not because she couldn't still live, still go out and enjoy family get togethers, holidays and life, but because she became depressed that she had the condition. She stopped eating properly, refused to go out, cursed whenever sent to hospital to pick her up again, she didn't die from emphysema she died from not eating. It was a complete waste, she could have had 5 more years of life valuing that time she had and living it to the full, her family were heartbroken that she did not wish to try. Perhaps if she had been treated for depression it would have made a huge difference.

Some people do give up too soon, life can still be lived, once a condition is accepted and that is the key here accpetance and finding out if life can still be enjoyed regardless. There are people paralised from birth, some from accidents, some from illness along with all the other terminal type illnesses out there, some people carry on with a smile, some will try with gritted teeth and eventually come through, some give up, but should a condition warrant being euthanised, as many people with the same condition will try to live with it too.

We can never say that a person can kill themselves just because they want to, it has to be, if ever granted because a condition warrants it. Does being paralised warrant death? IMO no, because many people who are paralised live good lives still, with support, so a court IMO can not give permission for this case.

It is the same as saying those with depression and who give up on life (and there are probably thousands of people like this) should also be able to go to a court and be allowed euthanisation?

It is hard to find that balance of someone who is depressed with life just at that time and someone who truly should be let go, and if the person concerned does not always know, how can someone else ever make that decision?

It is why it has to stay as it is. And I do have great sympathy for the man concerned, no doubt he feels as though his life is not worth living, but IMO it is a state of mind not just the condition in which case how can it ever be legally ok'd.

What people choose to do themselves is another story, many do end their lives.............. and if going to Switzerland is something people wish to do it is up to them, just as taking their own lives is, but I don't think it should ever be made a courts decision, unless for things like turning off a life support machine when the brain is dead etc, it morally IMO would be wrong.

> What people choose to do themselves is another story

But that's the whole point about this case, and others like it, isn't it?  He cannot do it himself, he wants to die but he MUST be assisted to do it.  He's simply after a ruling to say that whoever helps him will not face charges for doing so.

If he was able to do it himself it would be another matter - he could just do it and that's that.  But that's the problem.

>I find it isn't as easy as just travelling to Switzerland.

Anyone taking him would be prosecuted on their return.

    I find it isn't as easy as just travelling to Switzerland.

Anyone taking him would be prosecuted on their return.

In general they are not though, as we have quite a few go over every year from this country.

Also the courts rulling was that it should not be upto the courts to decide on these cases and that it should go through parliment.

I should have said "could" be prosecuted, not "would". A prosecution can only be brought if it's deemed to be 'in the public interest', but the maximum sentence is 14 years. I think it's fair that people would like to know that their loved ones wouldn't face that.

Yep i agree, for some its just to much of a risk but i think if it was me i would do it.

He cannot do it himself, he wants to die but he MUST be assisted

These same people who are fighting for him to die, why do they not focus on fighting for him to live.

Yes, he is totally immobilized, a prisoner in his own body, but he still has sight and sound and smell he can still listen to loved ones talk to him, read to him, watch tv with him, tell them their day to day funny stories etc, he can still be taken out in a wheelchair to sit by lakes, woodlands, he can still look at the sun, the moon, feel rain and sun on his face, he can communicate by blinking and if worked on I'm sure a shorthand system can be worked out to get across much quicker what he would/would not like to do.

He can still watch his children/grandchildren play and laugh he can still be sat around a table with them at Christmas, being paralyzed is not the end, he just thinks it is and so does his wife, who probably finds it harder to accept than even he does.

Being immobile does not mean that life has to stop being good and fun, the people around you and the care that you are given makes the difference to many as to whether they wish to live or die, his mind is still there he can still think and feel and what everyone is forgetting enjoy life too.

The simple things in life make life worth living and if maybe those who love him the most would try to think that way for a little he would no longer wish to die and would find a reason to live?

How do you know his wife has not exhausted all that, to me she looked very much concerned by his well being, she kept touching him on the arm and trying to gee him up.
He does not want someone else to be have to do all those things for him and his wishes should be respected not talked to like he is impossible of reaching his own conclusion.

I dont think she is fighting for him to die i think she is merely assisting his wishes and respecting him as a individual.

>if maybe those who love him the most would try to think that way for a little he would no longer wish to die and would find a reason to live?

Why do people insist on thinking that they know better than the man himself ?

I think that this sums up my feelings:

You do not set the standard.
You have not walked in my footsteps, danced in my shoes, or lived in my world.
Do not judge me, point your fingers at me, or become experts on my life. Instead, celebrate with me in times of joy and cry with me in times of pain.
Only then will we begin to understand each other.

Kate Baker

Why do people insist on thinking that they know better than the man himself ?

Because sometimes we may feel things are hopeless when they are not, I dare say plenty of able bodied people who have lost only one or two limbs mobility wish to die too, thankfully they don't.

The courts have decided they will not give their legal permission for him to take his own life, whether we agree with that or not it is the law.

If his loved ones decide to break the law and help him, personally I would hate to see them get anything over 6 months due to the circumstances but the law is not always fair.

It is a minefield of rights and wrongs and emotions and that is why courts just cannot say yes, but I don't know what the answer is.....

> I dare say plenty of able bodied people who have lost only one or two limbs mobility wish to die too, thankfully they don't.

But they are able to exercise their right to die if they so wished. How would you know what your breaking point is unless you reached it ?? It might be lower than you think - hopefully few of us will ever reach that point :(

How would you know what your breaking point is unless you reached it

We either do or don't believe in suicide, I don't! It's not a religious thing it's just how I feel about life.

The law of the land cannot be seen to agree with it either, whatever we feel it is just that simple. :-(

The judge did not say they don't agree simply that it is a process that needs to go through parliment.

> The law of the land cannot be seen to agree with it either

Suicide is not illegal, just the assistance by another person.

> We either do or don't believe in suicide, I don't

That's easy to say when you aren't at your breaking point.

Because this is such an emotive subject, we have to step back and allow people not emotionally involved and easily swayed by tears who think of all the pros and cons to this, if The British Medical Association has said the court made the right decision, we have to trust that it is the right thing.

> if The British Medical Association has said the court made the right decision

I agree that the court has made the right decision - the court upholds the current law which is the correct and only thing that it can do

It needs changing though l think we all agree. How that change will happen is the problem.

Myself and my OH are very much in agreement that if we ever find ourselves in a situation where we are able to communicate that enough is enough (depression aside as I think physical and mental do go hand in hand ) they we would both help each other.

You are allowed to say enough is enough as a next of kin when things get so bad and also to give permission to do an operation so really what is the difference ?

I really want to comment on this , to nobody in particular.

Having worked in 'Care' forever, and with personal knowledge of a family who used dignitas and the repercussions I feel entitled to a voice.
People and relatives of sick people are a queer bunch! I have met some wanting to 'get on and make funeral arrangements' rather than sit with dying family members. I have met some who are at the other end of the spectrum who just wont believe there beloved are going or have gone!

But the fact is we are not ever to expect any other person to take responsibility for the death of another!
There must simply never be any legislation allowing it.
The right decision was made.

Karen
 

>You are allowed to say enough is enough as a next of kin when things get so bad and also to give permission to do an operation so really what is the difference ?

A very valid point. A third party has the power to terminate someone else's life when they're unable to agree to it, but not when they are able to ...

>But the fact is we are not ever to expect any other person to take responsibility for the death of another!

It happens every day when life support machines are switched off.

Some people keep saying that this guy can communicate..

Do you have ANY idea how tiring and difficult that form of communication actually IS? He can't hold proper conversations, someone has to read out the alphabet to him and he blinks yes or no for each correct letter, until he forms a word, and then builds up a sentence.

Much of his life will be conducted via yes/no questions because this will be faster, and that depends on the carer being clever with the questions so as not to waste time.

His form of communication is absolutely  NOTHING like being able to speak or even use a computer that works on eye movements. Just asking for what he wants to eat for breakfast will be a long, time consuming and tiring business.

I do have a clue what it is like when your ability to communicate is drastically lower than your ability to think, question, etc - some of my health conditions can mean that I am gasping for breathe and can speak one word at a time. Fortunately it hasn't been that bad in quite a while, but even just THAT and I could still speak, albeit slowly and disjointedly, is endlessly frustrating.

YOu stop having conversations, they are pointless, because if you can ge tto the end of the sentence you thought of without forgetting it, the person you are speaking to probably has lost track. You forget what you wanted to say,  you limit yourself to the bare essentials, and then of cours epeople think you are being rude if they hear you talking to someone else because you have cut out all the waffle, the please, thankyous, and you are now saying things like 'Hubby. Tea?' and 'Let out dog!' and not 'Ooh, shall we have a nice cup of tea hubby dear, mm I would quite that' and 'Oh, I think the dog wants to go out, would you be so kind as to open the door, thankyou'.

It is also pretty horrific having to rely on your loved ones and also on strangers, to do EVERYTHING for you - again you begin to cut down on the things you want to do. Sure, Tony Nicklinson can go and see his kids do things, go outside and enjoy a sunny day, watch tv - but every single one of those things involves someone else, several someone elses, putting themselves out, making life much much harder for them - and the icing on the cake is you can't even have a conversation and thank them and make them aware of how much you appreciate it, you can't explain things quickly and succinctly to make th ejobs they need to do easier for them.

I would suggest that those of you who think that his level of communication means he ought to suck it up and stay alive.. just you spend a week immobile and unable to speak, just blink. Just experience lying in your own faeces, because the person caring for you wasn't quick enough to realise you needed the loo, or they had nipped off to do something else, and now you k now that THEY have to clean you up, change your pants, change the bed... you watch life going on around you and know that every single thing it takes to keep you free from bedsores and without a dirty backside involves someone else working hard, in many cases a partner or child doing these things for you... and then if you want to do MORE than just lie in bed or sit on the sofa in front of the tv, its going to take that person ten times more work...

I'll bet theres looooads of reasons none of you would ask your partners to look after you for a week of seeing what locked in syndrome is like!

But, don't you realise this type of care will be needed in variation to a large percentage of the population anyway....... it always has. Millions of people all over the planet are doing just that.

Our grandparents, parents even children and eventually us, unless we die of something quick will need care, from strokes to MS to just getting too old to hold your bowels and urine, most of us have already witnessed this happen to family and friends it is a part of life and death.

We're supposed to take care of our ill and old,

I hate that word burden and to many it is just that, and the person needing the care...... knows it too. :-(

Can you imagine all those millions of people being allowed assisted suicide and taking it, not necessarily because they want it, but because they know they are a burden, how many relatives would plant that seed?

There is no way of knowing who genuinely wants out and who are doing their family a 'service'. We talk about dignity, well we had our bums wiped for us when a baby/toddler, so we end up that way eventually again, it's the way of life, my grandfather did it with a smile and made a joke of it when my grandmother had her stroke, she also was in a wheelchair and she also could not talk, just made a slurring noise which none of us understood though my grandfather seemed to know. :-) She lived for another 4 years and none of us ever made her feel a burden and we saw her smile through her eyes.

There are wonderful carers and medical staff out there and wonderful families too.

If this man now hates his life I feel very sorry for him, I really do.......... I have no answer for him and others who feel this way, but to give someone else that 'burden' of ending his life to me is a step too far.

I don't know what happens to us when we die, I'm open to all suggestions :-D but, the way I look at it is when your dead your dead, the end! I just think life even incapacitated life is better than none, I would find something to live for and look forward to, even if it is just seeing and feeling the sun rising and setting, but that is just the way I look at things, I know many don't.........

> It happens every day when life support machines are switched off.

Such a good point.  I wonder in how many life support situations there may be hope, maybe even years down the line, of the person recovering to some degree - but the next of kin have to make a decision based on the situation as it is.  And how many coma patients are in fact aware of their surroundings, but totally unable to communicate - there will be situations where the machines are turned off and the patient has no say in it.

Yet this man has very clearly expressed his wish to die, and has been denied it.  I don't get the feeling from him at all that he wants it so he can no longer be a burden on his family - he wants it because he cannot bear to continue living as he is.

>Yet this man has very clearly expressed his wish to die, and has been denied it.

When someone expresses a wish to live their wishes are respected. If the same person expresses a wish to die then their wishes are ignored and they're effectively punished for it. How civilised is that?

>well we had our bums wiped for us when a baby/toddler, so we end up that way eventually again, it's the way of life

When we were babies we knew no different - we hadn't been taught physical 'dignity'.

We house-train our puppies and know how distressed our adult dogs get if, through illness or our absence, they have an 'accident' indoors. And we think compos mentis human beings are fine with this? When they realise that it's never going to get any better they will, with luck, become resigned to it - but there will always be the shame that they was instilled into them from their primary school days onwards.

>She lived for another 4 years and none of us ever made her feel a burden and we saw her smile through her eyes.

You think she never felt that she was a burden; perhaps she was just a very kind person who hid it well. I know people just like that.

> xmlns="http://www.w3.org/1999/xhtml">Our grandparents, parents even children and eventually us, unless we die of something quick will need care, from strokes to MS to just getting too old to hold your bowels and urine, most of us have already witnessed this happen to family and friends it is a part of life and death.<br />

My husband hated that part of his illness and although grateful that I dealt with that aspect for him and knew I didn't see it as a burden just another part of my love for him he felt totally degraded by it and to see a grown man cry because he dreaded me having to get our son to come and help lift him from the floor of the shower after he had had an accident was heartbreaking. He begged me not to let his son see him like that - helpless and distraught - but I had no choice as I couldn't lift him by myself. Our son was wonderful - my husband was pleading with him through the door not to come in and D was reassuring him that it was alright and he was just going to help him as his dad had done for him when D was little and he felt honoured that he could pay back a little of the love and care he himself had received. Steve fully understood his son was helping because he loved his dad and that it wasn't a problem for any of us to see him like that - but to Steve himself it was a huge problem and also highlighted the fact that he no longer had any control over his own life.

Having to rely on someone else 100% of your life for everything you needed was not how he wanted to be - yes he did appreciate the beauty of  sunsets still as we placed his bed by a window so he could look out into the garden, yes he did love his family, yes he could listen to the radio and could still hold your hand as you sat by him but he also knew he had reached a point where he didn't want to remain in this world any longer and that slowly but surely all the little things he could still appreciate were slipping away from him as he started to lose his sight and his hearing, lost control of his bodily functions and became a mere shadow of his former self. It didn't matter that we all still loved him, that we never made him feel as though caring for him and loving him was a burden - it was how he felt and he was the one "living" that life. On the day that he died we were all just willing him to go - we didn't want to lose him but we also knew that he just couldn't go on as he was and in reality if he could have left us three months before he did it still wouldn't have been too soon for him and he would have chosen to go.

Maybe it is different when people are older Carrington but I think people who find themselves in that situation when they are not "old"  can't always deal with it however much love and care is there for them. Personality also plays a big part - what one person sees as a problem another might not even notice, what upsets one person can be the very thing that another person deals really well with, some people thrive with adversity, others crumble and fall. We never truly know how we will react in a given situation until we are actually in that place and sometimes we are surprised when our actions and reactions are the complete opposite of how we thought they would be.

Carrington, I am 100% happy with the way you have put this.

It is also my view that we take care of one and other, not legislate to make it easier to salve consciences about finalising life.

Yes I have suffered indignities, also helped others when they have had to suffer with them......its part of life and living.
Still where 100 years from now would people like to draw lines about how much we should 'allow' before considering euthanizing.

Life is not easy or perfect but please,please dont lets get above ourselves.

Karen

> xmlns="http://www.w3.org/1999/xhtml">It is also my view that we take care of one and other, not legislate to make it easier to salve consciences about finalising life.

Wow - we took amazing care of our loved one but sometimes however much one is loved and cared for the late stages of a terminal illness can make some people decide enough is enough. I don't think legislation in such cases is about salving people's conscience it's about allowing death with dignity at the request of the person who is suffering the most - the patient. As much as we wished he would leave us so he could be at peace at long last we were all wracked with guilt for feeling this way and even more so when he did finally go.

> These same people who are fighting for him to die, why do they not focus on fighting for him to live.
>

Well said and the rest of that post.
  I do not particularly blame his family as they will be as influenced as he when they hear some of societies attitudes about the profoundly disabled, even possibly from the medical profession! and when they show pain and pity for his situation it can hardly lead to any possitive feeling for him.
As a child of a profoundly disabled person I know they can have a very relevent role in family life.  I do not accept that is idealist to expect that the be achievable for others in the same situation when they are given the right care and motivation.

I agree with Dogz that family and friends deal with impending death in different ways, those you think understand what is going on or staff when questioned during hand over tell you they are aware clearly didn't when the event happened, having been caught out too many times I got into the habit when meeting family/friends of a dying patient for the first time[working nights meant you rarely saw them otherwise even though you may have nursed the patient for decades] of taking next of kin and finding out what they were thinking/expecting to happen, this allowed them to ask me questions away from the bedside, the one I could never answer was how long was it going to be, I encouraged them to stay at the hospital if they wanted to be present, we had sofa beds in a seperate room or recliners which could be brought in by the bedside.

I never blamed anyone who didn't wish to stay, they may be elderly/ill themselves or not had a very good relationship with the person, some want to be told over the phone but not come in others want to see them before they leave the ward. I never rushed a patient off a ward till the family and friends are ready to leave, this could be a few minutes and don't tell you they are leaving or several hours.

I was present when the ITU nurse came to tell us that my 29yr old brother was brain dead 9 days after an RTA, he was ventilated on admission due to needing sedating as he was very agitated, 3 days later he had a stroke, then 3 days later taken off the vent and started to come round,obeyed commands but wasn't withit enough to speak, was revented as he was going for major surgery on his badly fractured leg the next day, he had the surgery and it took less time than was expected and he was to be woken up the next day, during physio the next morning he had a cardiac event, his heart was scanned and nothing found so things continued as planned, neuro obs at 3 pm were normal for him, at 4 pm things had changed dramatically and further investigations showed he was brain dead, I was numb, his wife my Mum and myself had been there night and day, it had happened several hundred miles away from home. A senior Dr who I knew from when he had been a junior Dr at the hospital I was working at came and had a chat and discussed transplant which none of us had thought about, Mum knew he had carried a donor card from when he was old enough to do so and his wife signed the relevent forms, he had to be examined by different medics and at 7pm we went to say our final goodbyes. Next morning one of the Nurses from the transplant team came across to the nurses home where we had been staying to say that it had taken place the night before, I was really upset to learn that his heart had not been used because of the incident earlier that day but his valves had been saved, my first thought on waking up was that his heart would be pumping in someone elses body but that wasn't to be. It took me nearly 12 months to get back to work, I doubted my abilities, if I couldn't help my brother how was I going to be able to help complete strangers. When chatting to Mum several months down the line we wondered how Neil would have coped being disabled from the stroke as he was a very active person, he was forever tinkering with his car, did DIY at his house and areas of mine I couldn't reach,  played sports and went sailing in his in-laws boat, their house wasn't adaptable for a wheelchair and

Three years later I lost my Dad age 69 yrs from post op complications following surgery for bowel cancer, a body scan showed it hadn't spread, I was 300 miles away as my parents had moved back to Scotland the year my brother died, I had only been home 2 weeks as he was so much better and just needed to build up his nutrition and gain back the weight he had lost, it took me hours to be in a fit state to drive up north on my own bar for my cocker spaniel, it was the first time I had done the trip in the dark and without stopping. I was on automatic pilot, dealing with all the arrangements, comforting my Mum who had already lost loads of weight during my Dads illness, I would cry in the shower where no one could hear me, the last thing they needed was me falling apart, my other 2 brothers came for the funeral, one only stayed 12 hrs the other one stayed a week, I stayed 5 weeks, taking holidays and sick leave, Mum then said she needed to start coping on her own and wouldn't with me still around so date was set for a week later for me to go home.

I reacted differently in each case based on the role I had to play after each death, I didn't love either of them any more or less than the other,with my brother his wife had her family to support her and their almost 4yr old son,only my friends realised the effect it had on me, with Dad I had to take care of my Mum and stay strong for her.

This goes to show that one person can react differently to losing close family members to sudden death, it also made me realise why I had seen so many different reactions from family and friends in the years before and could expect in the future.

Those of you who have never experienced serious long term illness yourself or as a carer don't know how you will react when there is no light at the end of the tunnel.

>Those of you who have never experienced serious long term illness yourself or as a carer don't know how you will react when there is no light at the end of the tunnel.

A very moving post, Rhona, and your final sentence is very true.