The Hill – Episode 5/7, His son arrives

Laura got the bleep at 9.15. She was on the post take ward round, still a couple of hours away from being released. It was Carlos. “Err Laura, you'd better get up here. Albert Johnson's son has arrived and he's NOT happy.” “About what?” “About the state his Dad's in.” “What state?” “Oh everything. The... Continue Reading →

The Hill – Episode 4/7, Admission to the high depedency unit

By 2AM Albert was simultaneously low in oxygen and high in carbon dioxide, both resulting in drowsiness. Laura admitted him to the high dependency unit (HDU), an area that she, as the most senior medic on site, was managing. She asked the nurse in charge, Carlos, to apply the tight mask. In order to measure... Continue Reading →

The Hill – Episode 3/7, Laura and Mary talk

  Dr Laura Green asked Mary Johnson to join her in a quiet room. Dr G: Mrs Johnson, I'd like to talk about Albert's illness. I'm very worried about him. The chest infection, pneumonia, is severe, and... Mary: You don’t think he can survive? Is that what you wanted to say? [she was not aggressive,... Continue Reading →

The Hill – Episode 2/7, Mary’s view

  "What Dr Green didn't seem to know, when she started to speak to me, was that three months earlier we had been in the same department with the same problem. It was like deja vu. Same time of day, same department. Albert had a chest infection, he was gasping for breath terribly, and an older male consultant... Continue Reading →

The Hill – Episode 1/7, In the Emergency Department

  Welcome to the second series of short episodes on the Illusions of Autonomy blog. The Hill describes a 'difficult' treatment escalation and Do Not Attempt Cardio-pulmonary Resuscitation (DNACPR) decision. By 'difficult', I mean the process of reaching agreement with a patient and family who have not been engaged on the issue before, despite end-stage... Continue Reading →

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