Autonomy

 It seems strange to others that this is the stumbling block

Not the security situation ever fragile

Not the financial situation so divided

Not the systems or lack thereof

No 

The concept of secrecy being the best medicine

The deeply engrained concept that knowledge leads to loss of hope

That if only loved ones are kept in the dark they will not give up 

And that in their ignorance hope remains alive

The vast majority of my medical career has been practiced where the reverse is hammered into our brains

We attend courses on how to do it

We observe seniors

And are observed and signed off before being let loose on patients alone

Autonomy is the goal

Knowledge is the only way to consent 

Consent the only route to treatment 

And only if discussed openly can wishes become the whole team's aims

I was the one who explained the scan to my mother

I was the one who translated medical jargon into steps and durations

"You can tell me, I will not break down don't worry" she told the consultant on the phone informing her that nothing could be done

We had four weeks 

We all dropped everything and moved in 

We screamed, shouted, cursed and cried 

There were nights of truths never previously spoken

And our relationship with each other will never be the same again 

But

As she lay on her bed with two daughters curled up on the ground on either side of her bed

She whispered "time to sleep girl"

And there is peace in knowing we knew she knew we were there because we wanted to be