D. Robin Taylor was Professor of Medicine at the University of Otago, New Zealand until he returned to Scotland in 2013. He is a consultant in respiratory medicine at Wishaw General Hospital, and is Honorary Consultant in the Primary Palliative Care Research Group, Faculty of Medicine in the University of Edinburgh.
Based in Edinburgh, he has been closely involved in implementing Treatment Escalation and Limitation Planning in acute hospitals, coaching consultants in patient-centred decision-making, and promoting “prognostic conversations” for patients experiencing severe illness.
Coping with Crisis
This booklet had its beginning in 2010 when I was a consultant physician in New Zealand. Together with ward staff, I was looking after a Mr. Johnstone (not his real name) and it seemed that everyone was “doing their best”. However, the care we provided was actually inappropriate. Instead of common sense and compassion, Mr. Johnstone was treated aggressively by on-call staff and it resulted in greater suffering for a man who was in the last days of his life.
The right conversations didn’t happen. There was no sense that letting go might be better than clinging on. When he deteriorated, medical treatment was stepped up and his real needs were neglected.
His family were very distressed by what happened – and so was I. I vowed that I would do everything possible to make sure that it didn’t happen again to a patient under my care. Since returning to Scotland, I have become even more aware of what patients and their family members often struggle with when they arrive in a hospital ward. This is especially true if the situation is lifelimiting or life-threatening.
This booklet is part of my response – to try to help people through some of the tensions and difficult decisions that so many have to navigate when someone is critically ill. I hope that you find it helpful even if the topics are not necessarily easy ones to think about.