Multiple Sclerosis

In 2022, I worked in a small emergency department in a little town. The morning was quiet so far, and my colleagues and I were waiting for a relocation of a patient. An ER is not just about emergencies. Occasionally, a patient is treated for a serious condition in a bigger clinic, which is unfortunately not so close to their homes. Once they are stable and do not need the expertise of a University Hospital, they get relocated for further care to a smaller hospital, closer to their home. Well, this was one of those relocations we were waiting for. We did not know many details, just that he had MS (Multiple Sclerosis) and was in his mid-30s. MS was a delicate topic at the breakfast table, as one of my dear colleagues just got diagnosed with it. She was my age and sitting there with me. Her symptoms were slight at that time, but she was full of emotions and fear about the future. Who would not understand that!? So, naturally, I said that I am going to take care of the patient once he arrives.

By about 10 o'clock, the ambulance came and announced they were there with Michael (name changed). We got a brief handover from the ambulance staff and learned about Michael's journey. Already now, my heart grew heavy, and I was very touched by his story. This is why I want to share this story with you:

Michael was a 32-year-old MS-patient. His symptoms showed up in his early 20s and increased quite fast. As it often takes long to diagnose MS, it went on for several months until he and his family learned what had caused those symptoms. Michael used to be a very active and live-loving person, longing for adventures and living life to the fullest. He was in his studies and enjoyed his freedom. When he got the diagnosis, he was, of course, devastated. His family was shocked, and nobody could believe what the doctors just said. 

All started with unusual fatigue and the inability to concentrate during his lectures at the university. First, he thought he needed to rest some more and take life a little easier, but when he experienced loss of strength in his hands and a worsening eyesight, he decided to see a doctor. Many tests later and numerous specialists later, he got a call from his GP, who wanted to book an appointment with him. He instantly knew something was far from good. It was the next day he saw his doctor, supported by his mum. The GP took his time to explain the test results and to communicate what this meant for Michael. His mum and him slowly understanding the consequences of what he said. 

Unfortunately, Michael's symptoms proceeded quite aggressively, and within a year, he experienced a long-lasting loss of strength in his hands and feet. Walking became harder, and writing almost impossible. Some days, he couldn't even go to the bathroom by himself. After 3 years, he was already dependent on a wheelchair, and going to university became, due to his decreasing ability to concentrate, extremely difficult. When he lost total control over his lower extremities and his bowels/urinary track, he fell into a deep, dark hole of exasperation.

He tried to find some peace with his situation and make the best out of it, but eventually, he lost interest in life and did not see why he should move on.

Living close to Switzerland, he was well aware of the fact that there is help to get him out of his misery. He started thinking about euthanasia. As one can imagine, the family was not willing to help with this and drive him to Switzerland to get what he so much desired. He just wanted to find peace and live without pain and a weakening body that did not feel like it belonged to him any more. So he took things in his own hands and found some guy on the internet who would provide him with the medicine that would end his agony. 

Day X came, and he waited until his parents went out for a trip. He said he didn't feel well, and he wanted some time for himself. So they went on, and he was alone. Finally, where he wanted to be since he got the medicine — alone at home.

He took time to write a letter for his parents, listened to his favourite tunes, and ate his favourite meal, which his parents prepared for him before they left.  Once he found the right mindset and felt that he was ready to say "Goodbye!" to the world he knows, and "Hello!" to the world he hopes to find, he took the medicine, fortunate enough that his arms would still follow his commands and did not spill everything on the floor. He fell asleep, he felt how his heartbeat slowed down and how his mind became misty. Still listening to his favourite tunes … 

Suddenly, everything is loud, bright, and too much! People are screaming, crying, and someone forces something onto his mouth. He felt sick to the bones and was confused. What had happened?! This is not the world he expected to find!? He made out the voices of his parents, and he understood: it did not work. I am still stuck here. Devastation. Exhaustion. Despair. … 

And pain — an undescribable amount of pain in his limbs and his chest.

Disbelief …

Realization …

The following days were blurred in a mist as they passed. He fell in and out of consciousness. After the first week, he was conscious enough to be able to listen to the doctors about what had happened. Apparently, the guy who sold him the medicine did not consider the weight of Michael, so that the medicine was simply underdosed. Unfortunately, this caused the circumstances Michael was in. He could not believe it. How could he have been so stupid!? Why did he not contact a proper organization, but choose the guy on the darknet?

Back to the day I met him: 
After the handover from the paramedics, I welcomed him and started my first examinations. Of course, I had to ask him for his story, and he told me everything right away. We felt instantly connected, and I had to think of the movie "Me before you" (2016). Fortunately, the ER was still quiet and I could take my time to listen.

What I did not know was that after his suicide attempt, his condition was much worse than before. Now he couldn't even move his arms any more. Taking his life, once more, was not possible without the help of others. And he was so broke. Of course, he was! I felt so sorry for him. Considering the bravery he had and the fact that he was ready to leave the world with all the consequences shows how desperate and certain he was. Now he was left with his dark thoughts, pain, and a body that did not do anything any more. On top, he was still suffering from a lung inflammation and needed suction because he wasn't strong enough to cough. I felt his desperation deeply. 

Very ill patients with a weak body are, of course, nothing seldom for us. Young people, with a non-functional body but such a sharp mind, are nothing usual, though. It broke my heart to see him there, waiting for his end to come.

Working in an ER means that you see your patients only a few hours until they move to one of the wards or are dismissed. Usually, we don't see our patients afterwards. After my shift I went for a visit, though, and talked to him about all kinds of things. I visited him every day before or after my shift, talking about vegan food, disgusting fast-food and our favourite books. When he was finally released to go back home, it was hard for me to say goodbye because I knew I won't see him again. He was going to find peace soon. 
One way or the other …