Dying for palliative careBMJ 1994; 309 doi: https://doi.org/10.1136/bmj.309.6970.1696 (Published 24 December 1994) Cite this as: BMJ 1994;309:1696
He died on 19 August 1994, aged 69, nearly five months after having acute myeloid leukaemia diagnosed. He had suffered from asthma since 1984. Jeffrey and I had shared our lives for over 30 years, and we knew that he had only a short time to live. I made a diary of events for two reasons: I found it therapeutic and I wanted to record my increasing concern at the apparent lack of interest in the quality of Jeffrey's life.
The illness started in August 1993. Jeffrey slipped down a small trench. His right ankle became swollen and he began to feel ill and after about a week he was so weak he had difficulty in climbing the stairs. Our general practitioner arranged for Jeffrey to go to hospital, where he was found to have a cardiac effusion and to be anaemic. There was no diagnosis. He became worse and was readmitted; his haemoglobin concentration was 79 g/l, and he was given a blood transfusion. His doctor seemed obsessed with AIDS related diseases, but Jeffrey refused an AIDS test. He was given ferrous sulphate tablets and told that he probably had a viral infection. Jeffrey and I then left for South Africa, where we intended staying at our house until the end of April, but in March he became weak and anaemic. He had a blood test and was immediately diagnosed as having leukaemia. After receiving five units of blood he was well enough to fly to London.
Through a friend we arranged to see a consultant at another hospital, who referred us to the haematology department. We were told that the condition was serious but in 50% of cases people were cured. When it was discovered there were sideroblasts the success rate was reduced to 25%. It was not …