This Is How It Ends

This Is How It Ends by Kathleen MacMahon

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Authors: Kathleen MacMahon
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was going to go all the way.
    He was overcome by a wave of weariness.
    He sat there slumped over his desk, his shoulders falling forward in a gesture of defeat. His head felt huge and heavy, the weight of it too much for his neck. He let his forehead drop forward, his chin fell in towards his chest, and he closed his eyes for a moment. He felt like a Christian martyr, waiting to be thrown to the lions.
    The papers would lap it up, he knew that. It had all the elements. A young mother, dead before she turned thirty. Two small children left with no one to care for them. A heartbroken husband struggling to earn a living, a pair of angry parents out for revenge. A routine procedure, that’s how the papers would describe it, a needless death. They would refer to Hugh as the eminent professor. And in the careful phrasing of their copy they would imply that there was plenty more that they couldn’t say about him for legal reasons.
    When the details of the case came out, there would be a debate. There would be talk of the need for new standards. People would say this kind of behavior just isn’t acceptable anymore. They would call on the Medical Council to publish industry standards, they would demand new guidelines on dealing with patients and junior staff. They would talk about the importance of a good bedside manner, they would suggest that this be included in the syllabus.
    They would say it was time for a changing of the guard.
     
    THE MOST DIFFICULT time in his life.
    Not that there haven’t been difficult times before, of course there have. But he was always equal to the challenge. He always put his shoulder to the wheel. That’s what he’s done his whole life, he’s always been a worker.
    Sixty-four years old, which means it’s forty-six years since he embarked on a career in medicine. There’s a symmetry to that, he can’t help but think. There’s something neat about it. If he keeps on going to his retirement date, that much will be lost. In his heart he knows he won’t make it to his retirement date.
    That’s all the thanks you get. Forty years working at it, fifty weeks a year. Twelve-hour days, fourteen-hour days. Saturdays and bank holidays, he even made his rounds on Christmas Day. He made a point of it, bringing the girls with him if he had to. Phone calls in the middle of the night, patients with all sorts of complications. Conferences and bloody case conferences. He never once complained about the workload. Whatever had to be done, he did it. He loved being a doctor. He still thrilled to the sound of the word.
    If only they’d just let you be a doctor, if only they’d let you practice your trade. But no, you had to be a bloody psychologist now as well. You had to be a social worker too, you had to submit yourself to interrogation. They’d all been watching too much ER , these people, they’d all been looking things up on the Internet. They wanted to know about all the available options.
    There are always options, that’s what he liked to say to them. The options are these. We can treat your mother as best we can, in which case there’s a good chance she will survive. Or she can choose not to receive treatment, in which case she will almost certainly die.
    Very few people appreciated his frankness. There was even the odd complaint. People had no bloody sense of humor anymore, they couldn’t take a joke.
    He doesn’t understand the language people use. He doesn’t know where they’re getting it from. They talk about consultant cover 24/7 and they talk about thinking outside the box and they talk about face time. They’ve started calling patients “clients,” for Christ’s sake. They talk about service providers and patient journeys. It all sounds like nonsense of the highest order, but as soon as you say that all you get is the raised eyebrows. They’re all playing the game, all afraid to say boo.
    They don’t even seem capable of keeping the hospitals clean these days. They’re riddled

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