A connection with family and the land

DR JILL BESTIC reflects on the importance of family in the remote top end of the Northern Territory.

I have been a medical practitioner for 36 years and I still regard my access to people in difficult situations as a privilege.

I recently returned from a General Practice as locum for a month in the top end of the Northern Territory.

I have, for many years, been interested in and have worked in palliative care. I was asked on my last placement to go to see a woman by one of the remote area nurses.

When I asked why, she said that she was not sure what was going on but she knew this woman well and she was not her normal feisty self.

I visited her home. I parked the vehicle, walked across the yard and into the house where I was met by numerous Aboriginal people in the main room.

The woman I had come to see was on her bed, had nasal prong oxygen on and was extremely thin, sitting up and not in distress.

This woman of 63 years had been sent back to her community three years earlier from Royal Darwin Hospital under palliative care plans for her advanced heart and lung conditions.

She was a feisty lady. She was, however, very frail.

After my examination of her I could not find anything acute or any condition that was requiring new interventions other than her personal care. In discussion with her, and suggesting her need for hydration, she told me she might or might not "pass".

I sat outside, under a tree on a tarpaulin with her family and we discussed the situation.

I told them that I thought that she was graciously dying.

The family, immediate and extended, told me that "my patient" had told them herself that she was "leaving the mob". They understood and just wanted to know how to maintain her comfort as she deteriorated.