Page 1 Page 2 Page 3 Page 4 Page 5 Page 6 Page 7 Page 8 Page 9 Page 10 Page 11 Page 12 Page 13 Page 14 Page 15 Page 16 Page 17 Page 18 Page 19 Page 20 Page 21 Page 22 Page 23 Page 24 Page 25 Page 26 Page 27 Page 28 Page 29 Page 30 Page 31 Page 32 Page 33 Page 34 Page 35 Page 36 Page 37 Page 38 Page 39 Page 40 Page 41 Page 42 Page 43 Page 44 Page 45 Page 46 Page 47 Page 48 Page 49 Page 50 Page 51 Page 52 Page 53 Page 54 Page 55 Page 56 Page 57 Page 58 Page 59 Page 60 Page 61 Page 62 Page 63 Page 64 Page 65 Page 66 Page 67 Page 68 Page 69 Page 70 Page 71 Page 72 Page 73 Page 74 Page 75 Page 76 Page 77 Page 78 Page 79 Page 80 Page 81 Page 82 Page 83 Page 8454 Plough Quarterly • Autumn 2016 who had introduced himself as Bill’s partner. “For the last couple of hours, really. More or less since he got home,” Ian replied, his anxiety and weariness barely disguised. “Can you do anything for him?” There was plenty of reason for worry. Bill, who had an AIDS-related lymphoma, had just been discharged from a hospital where he had been admitted for a type of pneumonia common among AIDS patients at the time. The hard truth of the situation was that he had come home to die. Ian told me that he and Bill had lived together for about ten years. Both worked in the media and had enjoyed successful careers. When Bill had been diagnosed as HIV-positive eight years earlier, they had coped and even thrived for a while. But once Bill developed AIDS-related illnesses, his freelance work had dried up, and Ian had had to be both caretaker and sole breadwinner. Those friends who had not dropped out of contact mostly lived too far away to lend anything more than moral support, while both their families wanted nothing to do with them. Two hours later, I had set up a new diamor- phine pump that would help Bill settle for the night and grant Ian a few hours’ sleep. Bill smiled as he held my hand and said thanks. Ian hugged me grimly and wordlessly as I left. The next day I came by in the late morning to check that they were OK. Bill had slept through the night and appeared less drawn. Ian also seemed more rested, but I sensed that he was not at ease. As I set up a new syringe driver in the kitchen, he came in and gently shut the door so Bill could not hear. “Is he going to get more like he was yesterday evening?” Ian asked. “As long as we can keep his symptom relief working, he will be comfortable,” I replied. “But he is going to get steadily weaker – I don’t think he is going to make any significant recovery from this illness.” Ian drew a ragged breath. “Can you give him all the morphine in one go?” “That would suppress his breathing and he could die,” I replied, suspecting what was coming next. “I don’t want him to suffer. Can’t you just . . . you know, fix it . . . so he drifts off peacefully?” The Final Moment I have cared for many men and women at the end of their lives, and try as I might, not all of my patients have had what one could call “a good death.” Some things are just out of one’s control. But I do know that not one of my patients suffered for want of good care. I knew lots of Bills who had poorly planned discharges and who needed lots of extra support when they got home. I experienced this firsthand with my own mother. She was discharged from hospice with no one at home to care for her. My sister had to drop everything to travel over a hundred miles to Mum’s house. Within hours my sister was on the telephone begging me to come and help her after Mum fell while trying to get off the toilet. My mother’s condition nosedived, so I relocated my very young family and my work for the next six weeks as we cared for her in her last days. The support we got from friends, family, her doctor, and community nurses made all the difference. As a result, my mother ended her days seeing her granddaughter taking her first steps. My father-in-law, an Anglican minister, visited so that she could share communion and worship from her sickbed one last time with her family. She died surrounded by her children, family, and friends in the bedroom she had shared with my father, who had died two years earlier, in the house in which she had been born seventy-two years