DARRYL CALVER: Now I know this is a hard question for you, and I, I know you've had difficulties trying to give me an answer before. But have I still got my two years? Is my two years still a possibility?
DR DAVID GOLDSTEIN, MEDICAL ONCOLOGY, PRINCE OF WALES HOSPITAL: The honest truth is no.
DARRYL CALVER: No, okay.
DEBORAH MASTERS, REPORTER: Around 75 per cent of deaths are expected yet few of us confront the inevitable.
DR DAVID GOLDSTEIN: Certainly in western societies, death is still regarded as an unnatural event that somehow can be put off.
PROFESSOR KEN HILLMAN, INTENSIVE CARE, UNIVERSITY OF NSW: I think for many doctors, perhaps even most doctors, death represents failure.
DR RICHARD CHYE, DIRECTOR PALLIATIVE CARE: I think a lot of doctors find it hard to say you are dying.
DEBORAH MASTERS: When modern medicine has nothing more to offer, when cure fails. Who cares for the dying?
(Excerpt of footage of Nurse doing patient rounds)
THERESE COMPTON, RN, SACRED HEART HOSPITAL: How's that pain that you had?
PATIENT: Still there.
THERESE COMPTON: You've still got it?
PATIENT: Yeah.
(End of Excerpt)
DEBORAH MASTERS: Tonight on Four Corners coming face to face with death. In an act of courage and generosity four Australians have allowed our camera to record the end of their lives.
DARRYL CALVER: I mean we talk about the journey of life, life being a journey. Well what about the journey of death isn't that a journey as well?
DEBORAH MASTERS: And we meet those who are determined to give them a good death.
(On Screen Text: A Good Death, Reporters: Deborah Masters and Matthew Carney)
DEBORAH MASTERS: This is no ordinary hospital. Two cats - Dex and Morph - named after the drugs Dexamethasone and Morphine roam the wards, patients are allowed to smoke and families can stay all day.
The patients at Sacred Heart Palliative Care Unit, a part of St Vincent's Public Hospital in Sydney, are all dying.
THERESE COMPTON: It's a privilege to be with people at this time in their lives. It's a beautiful place to be actually, it's a lovely place to work, there's a lot of life here amongst the death.
DEBORAH MASTERS: The staff here have made caring for the dying their life's work.
LOUISE EVANS, RN, SACRED HEART PALLIATIVE CARE: They're at the end of their life and their so appreciative for everything you give them. So it's a privilege to look after them and help them and just give them a little bit of TLC that maybe they wouldn't get in the acute setting because nurses don't have time.
RICHARD CHYE: I think all doctors should be able to do palliative care and the specialty has grown because all doctors don't want to do palliative care. They wanted to focus very much on the disease itself and therefore not as much on care.
DEBORAH MASTERS: Sacred Heart's Palliative Care Director, Dr Richard Chye and his staff are well practiced at delivering bad news. It's an essential part of the job.
RICHARD CHYE: I think a lot of doctors find it very hard to say you are dying. A lot of doctors can't say no to patient's families, very hard and it's not an easy thing for doctors to actually say no, I can't give you anymore treatment.
I tell my patients I know I cannot cure you but I can make you feel better.
DEBORAH MASTERS: And a doctor can't do that?
RICHARD CHYE: A lot of doctors would just say I can't cure you full stop. Whereas I would say, I can't cure you but I'll look after you. I will walk with you.
(On Screen Text: Norma Andrews, 80 Years, Bowel Cancer)
PATTY SMITH, NORMA ANDREWS' DAUGHTER: On the 16th of June they hit us with the one sentence which contained four things which was your mother has cancer - that was totally out of the blue, she has cancer, its terminal, its inoperable and she has days, possibly a few weeks left. I mean, ay ey ey.
DEBORAH MASTERS: Like most of the patients here Norma Andrews was diagnosed with terminal cancer. She came to Sacred Heart in June last year accepting her fate.
NORMA ANDREWS: I feel very lucky that you could be told like that and I bypassed all that nasty stuff - the chemotherapy, and everything they said it wouldn't do any good and there's no need for that.
DEBORAH MASTERS: But Norma Andrews has been waiting to die ever since.
NORMA ANDREWS: I just wake up every morning. I said "oh God I'm here again". And I just go to sleep every night and I just hope I won't wake up. That's the truth.
(Excerpt of footage of Patty Smith arriving at the hospital)
PATTY SMITH: Hello Mumma.
NORMA ANDREWS: Hello Patty.
PATTY SMITH: How are you today?
NORMA ANDREWS: Very good thank you. Lovely to see you.
DEBORAH MASTERS: Patty Smith is Norma's only child. This is Patty's 6th journey from her home in Perth to visit her mother since the diagnosis.
PATTY SMITH: This used to be your shirt.
NORMA ANDREWS: Yes I know, come here till I fix the collar.
DEBORAH MASTERS: With her mother's death imminent Patty was given the task of organizing Norma's funeral.
(End of Excerpt)
PATTY SMITH: It wasn't an easy thing to do but it's better to have something practical to do. Things like what date would you like, um that was a hard one. The coffin, the flowers, floral arrangements, what notices will we put in the paper. So when we got back to the hospital what does my Mum say? What are we having to eat?
PATTY SMITH: We've got a couple of menus, so we kept it fairly simple. Pork and ginger spring rolls with chilli lime dip. Crumbed calamari with tartar sauce.
NORMA ANDREWS: Oh kak. (Patty Smith laughs)
PATTY SMITH: Vegetarian risotto balls with provolone cheese...
(On Screen Text: Darryl Calver, 46 Years, Pancreatic cancer)
DARRYL CALVER: I mean I'm active, I'm young, I'm not as active as I use to be, but there's still a lot of things I want to do. Family, families become a big issue, you tend to take your family for granted a lot of the times until something like this happens.
My mother and I had not spoken for 15 years until this happened and now once again we're best of friends again.
DEBORAH MASTERS: Forty Six year old Darryl Calver and his partner Margie Howes planned to travel.
MARGIE HOWES, DARRYL CALVER'S PARTNER: Travelling the world, yeah, that's what we'd hoped to do. Our lives would be just travelling and visiting different places in the world but it wasn't meant to be.
DARRYL CALVER: (Singing) "Wherever you're going, I'm going your way". 'Cause we thought we'd be in it together and it's always our travelling song. Well I'm travelling and I'm going to have to wait.
DEBORAH MASTERS: It was only last May Darryl Calver, a chef, was told he had terminal pancreatic cancer. Darryl began chemotherapy to reduce the tumours growing in his abdomen.
MARGIE HOWES: We found that the chemo really did him the world of good. He had really no, not many side effects as people do from the chemo, and the chemo that he was having seemed to agree with him. It was keeping the tumours at bay, which was giving him quality of life.
DARRYL CALVER: There is a lot of times that I do feel fine, you know? I can go and have a nice beer and I can play some pool and have a bet on my horses. You don't really come to terms with it until such times as you feel the pains and you know you are not well.
DEBORAH MASTERS: When Darryl's pain became unbearable his oncologist referred him to Sacred Heart.
(On Screen Text: Friday November 27th 2009)
(Excerpt of footage of Darryl Calver in Sacred Heart hospital)
NURSE NICOLE: Hi Mr Calver, I'm Nicole and I'm from the pharmacy. These are all your medicines and this is a list of them and when you've got to take them during the day. Okay.
(End of Excerpt)
DEBORAH MASTERS: Darryl's spent the past two weeks in Sacred Heart in an attempt to get his pain under control. Today, he's going home.
DARRYL CALVER: I believe quite honestly that I've got probably 18 months left. And I want to make the most of those 18 months. So palliative care, anybody that can help me get over these pains and I don't care what it is I have to take, legal or otherwise, stop the pains so that I can go out and enjoy my last 18 months here on.
(Excerpt of footage of Darryl Calver leaving Sacred Heart)
DARRYL CALVER: Hopefully I won't have to come back but the door, I've been told, is open if I need to come back for anything else that needs to be done.
(End of Excerpt)
LOUISE EVANS: We do have patients that come over for convalescence care and short term care and we nurse them through the symptoms and then we see them go home and that's an amazing achievement to like send them home feeling much better so to actually see people walk out the door is, it's very rewarding.
(On Screen Text: Sandy Riches, 63 years, Breast cancer)
(Excerpt of footage of Sandy and John Riches)
JOHN RICHES, SANDY RICHES' HUSBAND: Have you got your wallet in there?
SANDY RICHES: I do darling. Thanks and keys.
JOHN RICHES: Have you got some cash?
SANDY RICHES: Yes I have some cash.
(End of Excerpt)
DEBORAH MASTERS: Sandy Riches and her husband John have recently celebrated their 40th wedding anniversary.
SANDY RICHES: I got a beautiful ruby ring, and I thought if I can hang around til I'm 50 he might buy me a really big diamond one (laughs). I don't know what's going to keep me. I'm very determined to be with my husband as long as I can be, because I know when I die, and I will die before him, I don't know what's going to happen to him so I've got to be here for him. I can't imagine him without me.
DEBORAH MASTERS: Sandy is on her way to Sacred Heart. She is one of around 250 patients well enough to remain at home. Sandy was first diagnosed with aggressive breast cancer in 1992.
SANDY RICHES: Well I think we were all a bit gobsmacked because we weren't really expecting it. We thought well that can't be happening I'm too young to have breast cancer because I was only about 46.
DEBORAH MASTERS: Sandy enjoyed 14 good years before the cancer returned. In 2006 she was playing her weekly game of tennis when her doctor called.
SANDY RICHES: And he said "what are you doing at tennis?" and I said "I play tennis every Friday" and he said "No, you have to come in straightaway" so he said "yes it's metastasized breast cancer and it's in your liver and it's in your lung and it's in your brain and you've got a piece in your, in your hip" sort of thing.
DEBORAH MASTERS: Today Sandy is at Sacred Heart's Day Centre where she'll spend time with other patients who share her trauma.
SANDY RICHES: Its mental anguish, you wake up every morning and you think "I'm still here you beaut". And it's a mental anguish that you go through when you have cancer and you know it.
(Excerpt of footage of Sandy Riches arriving at Sacred Heart)
KATE ROGERS, DIVERSIONAL THERAPIST: I've got a Christmas gift to give you or
SANDY RICHES: You've got a Christmas gift to give me?
DEBORAH MASTERS: Diversional therapist Kate Roger's job is to keep patients minds off their illness.
(Excerpt of footage of Kate Rogers presenting Sandy Riches with a photograph of Sandy wearing oversized novelty sunglasses)
KATE ROGERS: You never know what I find in the cupboard.
SANDY RICHES: (Laughing) That's last year 'cause Irene and I both wore our wigs.
(End of Excerpt)
KATE ROGERS: In ancient mythology and all that, it's the ferry that shepherds people who are dying over to the other side. And I think everyone in palliative care has their own little place on that ferry. I'd say my place would be ah the cruise director or the activities director, having all those sort of fun activities like the parties or the shuffleboard or the bingo or bowls or Wii bowling or anything like that. So it's making them have fun.
(Excerpt of footage of Sandy Riches at Sacred Heart)
ANNETTE, PHYSIOTHERAPIST: Just going to take you up. I think we've been to about, seen each other about three Christmases now.
SANDY RICHES: Three Christmases now.
ANNETTE, PHYSIOTHERAPIST: Go girl, that's what we're all about.
(End of Excerpt)
SANDY RICHES: And if I had to die in there that's what I'd do, I'd die in there or, I don't know - I don't particularly want to die at home.
REPORTER: Why is that?
SANDY RICHES: I don't want John to look across the bed and think "she died here". I don't want that for him.
(On Screen Text: John Peart, 53 years, Bowel cancer)
DEBORAH MASTERS: Father of three, John Peart was a keen sportsman with a larrikin streak. He was also a successful painter and decorator. He was first admitted to Sacred Heart Palliative Care unit in May 2009.
REECE PEART, JOHN PEART'S SON: The day we heard the word palliative, I actually looked it up on Wikipedia and the definitions quite shocking.
REPORTER: What does it say?
REECE PEART: Final life care, it says final stages of life care.
KAY PEART, JOHN PEART'S WIFE: When Reece looked it up we said you know is there something we don't know and they said no he's only there to manage his pain at the moment. But we never mentioned the definition to Dad just to keep his mind at ease, 'cause it was that bad, very, very bad.
REECE PEART: He said I keep making friends in here but they all die.
DEBORAH MASTERS: As the cancer spread and the pain became unendurable John was readmitted to Sacred Heart in early December last year.
(Excerpt of footage of John Peart at Sacred Heart)
JOHN PEART: Yeah, the bag works, it's still working, plenty of gas and air coming out of it. And I could eat the legs off a horse, I'm so hungry it's not funny.
(End of Excerpt)
DR KATHERINE CLARK, PALLIATIVE CARE SPECIALIST: He's gutsy, he demands answers, he tricks me on a regular basis, he's crook but he's, I never quite know what I'm going to find next.
DEBORAH MASTERS: John is one of Palliative care specialist Dr Clark's more challenging patients.
(Excerpt of footage of John Peart speaking to Dr Katherine Clark)
DR KATHERINE CLARK: We don't want anyone to be in pain. And pain is one of the most feared complications of cancer.
JOHN PEART: Sciatic nerve pain is incredible.
DR KATHERINE CLARK: It's awful.
JOHN PEART: I wouldn't wish it on my worst enemy, how bad it is.
DR KATHERINE CLARK: Yeah.
JOHN PEART: If they could bottle it in wars and throw it at other countries, the other country would win because the rest of them wouldn't be able to do anything.
DR KATHERINE CLARK: Yeah.
JOHN PEART: It'd be the end of them, oh it's terrible.
(End of Excerpt)
DR KATHERINE CLARK: John has very complex pain. He has a very large mass actually occupying a lot of his pelvis, he has pressure on something called the lumbosacral plexus which is a plexus of nerves that have come out from the spinal cord.
DEBORAH MASTERS: For the staff at Sacred Heart making sure patients like John are pain free and at the same time conscious and alert can be a real battle.
JOHN PEART: Like where your tailbone is, you know, like it feels like it swells up and it just throbs you know, it's just throbbing. And it goes, it just shoots down your leg here, down to your knee and that. It's just too much.
RICHARD CHYE: Ninety nine per cent of my patients will be comfortable without pain, but there will be a small number of patients whose pain is difficult to control. Yes we will go through lots of extraordinary means, medications to try and get on top of their pain.
(Excerpt of John Peart and family in Sacred Heart)
DR JENNY STEVENS, ANAESTHETIST, ST VINCENT'S HOSPITAL: John has an implanted reservoir attached to a catheter that goes near a spinal cord. So he's got some local anaesthetic and some morphine in the reservoir and that just feeds continuously into his spinal cord and he's had for almost a year isn't it John?
JOHN PEART: Yeah.
REECE PEART: You alright there?
JOHN PEART: Yeah.
(End of Excerpt)
DEBORAH MASTERS: John's family has been forced to watch him suffer. In this situation it's inevitable euthanasia will be discussed.
REPORTER: When the pain has got crippling had, had any of you talked about euthanasia? Has John ever indicated?
REECE PEART: Oh of course. Goodness me.
MELISSA PROCHAZKA, JOHN PEART'S DAUGHTER: Dad saw his dad go through it and Dad was always strong about euthanasia but obviously it's illegal but his theory was that if you're in that much pain then you shouldn't be sitting there suffering so, but....
REECE PEART: He always use to say "I feel like putting a gun to my head" but we know that he was divided over that viewpoint.
MELISSA PROCHAZKA: Yeah at the same time he was willing to fight you know, it was a balancing act.
REPORTER: What if it was available, what do you think would have happened?
REECE PEART: No doubt in my mind, ah...
MELISSA PROCHAZKA: Oh it depends...
REECE PEART: Then again, he's very variable.
DR KATHERINE CLARK: Most people want to live, most people want to live. There are a very small number of people and the number is so small over my career, I've been a specialist for gosh, nine years now. The number of people who remain firmly entrenched in the belief they want to die and die now, is so few they are memorable people.
DEBORAH MASTERS: Norma Andrews believes she should be allowed to die.
NORMA ANDREWS: Yeah of course I do. Well if you're thinking about can they give me a pill I know that that's not possible. I know it's not allowed or everything else.
PATTY SMITH: She would give anything that if it was legal now that is her wish, that she has done everything she needs to do and that every day that goes on she just loses a wee bit more dignity. The fact that she has been a very elegant lady all her life.
NORMA ANDREWS: What sort of a life is it when you've got to ask somebody to take you to the bathroom every time?
(Excerpt of footage of Sacred Heart's Christmas party)
DEBORAH MASTERS: Sacred Heart's Christmas party is one of the highlights of the year. The staff go to extra effort to ensure it's a memorable day. They are well aware for many here, including Norma Andrews this could be their last Christmas.
As the patients at Sacred Heart enjoy the celebrations it's a sobering thought to know most terminally ill Australian won't spend Christmas in a palliative care unit like this one.
(End of Excerpt)
KEN HILLMAN: Approximately 70 per cent of Australians die in acute hospitals. Getting sick at home, put in an ambulance, coming into the hospital, coming into the general wards, going into intensive care. It's that process which has happened subtly. And it's happened without any discussion with our society. It's just what we do.
And we do it for what we consider are the best interests of patients. We want to look after them. We want to cure them. And in doing so we've set up a situation where it's very difficult to die peacefully.
DEBORAH MASTERS: Professor Ken Hillman doesn't work in Palliative Care but recognizes it's a vital part of medical practice.
KEN HILLMAN: The patients that we get up to Intensive Care, we're often surprised to find that death and dying hasn't been mentioned to the friends and relatives, nor to the patient. This is often the case. Words such as "things aren't going so well. The treatment that we hoped would work doesn't appear to be working as well." It's more these sort of words that are dancing around the topic of dying.
REPORTER: Do you think an Intensive Care Unit is an appropriate place to die?
KEN HILLMAN: Oh no, no. Most of us who work in Intensive Care, doctors and nurses, when we see elderly patients, serious illness, about to die, then we all say to each other please don't let this happen to us.
DEBORAH MASTERS: Professor Hillman works in the high tech costly end of medical care.
KEN HILLMAN: I had six intensive care beds 20 years ago, and they're now building me 60 intensive care beds.
REPORTER: Because of the demand?
KEN HILLMAN: Yes because of the demand. But one could actually question whether that's real demand and whether the money or some of the money would be better spent in palliative care units, in community support.
DEBORAH MASTERS: Keeping dying patients out of intensive care isn't just good medicine it makes good economic sense. An intensive care bed costs around $3,000-$4,000 per patient per day, a Palliative Care bed like the ones at Sacred Heart cost a lot less.
DR KATHERINE CLARK: In New South Wales, a Palliative Care bed may cost as little as $600 a day up to perhaps $1,600 a day depending on the complexity of needs of the person in that bed.
DEBORAH MASTERS: Despite the obvious savings many doctors don't refer their dying patients to palliative care.
KEN HILLMAN: In the case of cancer patients, oncologists, they're use to referring their patients to palliative care. But the patients with terminal heart failure, liver failure, lung failure have an equally poor prognosis and they'll die often in a shorter time but they're usually not referred to the palliative care physician.
(On Screen Text: Tuesday 15th December 2009)
DEBORAH MASTERS: Darryl Calver is still at home. Today he's on his way to see his oncologist Dr David Goldstein.
(Excerpt of footage of Darryl Calver at a doctor's appointment)
DR DAVID GOLDSTEIN: Darryl, come on in.
DEBORAH MASTERS: Darryl's partner Margie Howes joins them.
DR DAVID GOLDSTEIN: Okay so now we need to really talk, so today we were going to decide whether we getting enough value out of this chemotherapy. The chemotherapy has really kept things under control for quite some time, quite a number of months but the facts are that finally this chemotherapy is escaping control,
DARRYL CALVER: So it's not holding it back?
DR DAVID GOLDSTEIN: No, so it's significantly worse than it was the last time we scanned it but I guess what's been happening it's been very slowly progressing during the last month or so and that probably explains why the pain has become more of a problem.
DARRYL CALVER: Now I know this is a hard question for you. And I know you've had difficulties trying to give me an answer before, but have I still got my two years? Well is, is my two years still a possibility?
DR DAVID GOLDSTEIN: The honest truth is no.
DARRYL CALVER: No, okay.
DR DAVID GOLDSTEIN: You've already done better than average for someone with your sort of cancer at your sort of stage. It's highly likely that the odds are that within the next two months you will get substantially worse and...
DARRYL CALVER: Within the next two months?
DR DAVID GOLDSTEIN: Yes, some people would say I've got to try the next treatment, the next irrespective of how long I've got and other people say well perhaps there are other priorities that are more important to me than yet another treatment with a one in 10 chance of working and that's what I need you to think about.
DARRYL CALVER: Yep, okay.
(End of Excerpt)
(On Screen Text: Friday 18th December 2009)
DEBORAH MASTERS: Three days later Darryl's made a courageous decision. There'll be no more chemotherapy. Instead Darryl will have a procedure in an effort to control his pain.
DARRYL CALVER: I mean we talk about the journey of life, life being a journey. Well what about the journey of death, isn't that a journey as well? Isn't a part of the journey of life also a part of the journey of death? Aren't they one and the same thing?
You know we are living to die and I believe that too many people will not confront or are not aware of the support that is out there to allow you to come to terms with death and the process that it's going to bring towards you and how you're going to manage with it. There is support, there is comfort, you don't have to do it alone.
(On Screen Text: Tuesday 21st December 2009)
DEBORAH MASTERS: At Sacred Heart John Peart's family are hearing the news they've been dreading. Dr Clark explains what to expect.
(Excerpt of footage of John Peart and family speaking with Dr Clark)
DR KATHERINE CLARK: I really think the trend is towards his life being very short now. I don't know how short though.
KAY PEART: We were just wondering how long it goes on like this?
DR KATHERINE CLARK: Don't know for sure. But when I see changes occurring on day by day basis I have to wonder if life is measured in days at the moment. I wouldn't be surprised if John's breathing started to change that's very, very normal. It may become noisy.
If you worry that's bothering John then we would intervene, we will only do things if you feel they are necessary to make him more comfortable. You may start to notice his hands become cold.
REECE PEART: Yeah we noticed that on the weekend.
(End of Excerpt)
DEBORAH MASTERS: The following day, to everyone's surprise John rallies.
(Excerpt of footage of John Peart and family)
NURSE: Someone sent flowers to you.
REECE PEART: Look Dad.
KAY PEART: Who's it from? What does it say?
(End of Excerpt)
DR KATHERINE CLARK: He did trick me, he did trick me, however I still do believe that John's overall prognosis is very poor. Each person does this in such a unique manner that we have to be respectful of it yeah.
(Excerpt continued)
REECE PEART: It's from Maroubra Medical centre.
KAY PEART: That's nice.
JOHN PEART: They must think we're really carking it.
(End of Excerpt)
(On Screen Text: Christmas Eve)
DEBORAH MASTERS: Darryl Calver's condition has worsened. He's been admitted to Sacred Heart. Nurse Louise Evans is on duty when Darryl becomes violently ill.
(Excerpt of footage of Louise Evans speaking on the phone)
LOUISE EVANS: He's bringing up everything he takes down.
DOCTOR: Can I give you a phone order for I/V Maxalon.
LOUISE EVANS: Subcoat you mean?
(End of Excerpt)
LOUISE EVANS: He was being sick so our emergency role was to try and get that sickness under control and we'd given the maximum amount of medication which we could give, so at that point it was important to get a prescription for more medication to, to try and control it.
DEBORAH MASTERS: An x ray reveals Darryl has a bowel obstruction.
RICHARD CHYE: When the bowels are blocked by the cancer itself, it meant that he wasn't able to take as much nutrition as he was before, it meant that he wasn't able to drink as much as before that's when his deterioration became much more marked, much more quick.
(Excerpt of footage of Margie Howes visiting Darryl Calver)
MARGIE HOWES: Hi darling, how are you going?
(End of Excerpt)
MARGIE HOWES: It's like a football match, this is only three quarter time, the games not over yet. There's still some way to go, and there's some still fight in him.
(Excerpt continued)
NURSE: Just been tackled sort of tackled to the ground by a great big front row forward, haven't you?
DARRYL CALVER: He's hurting,
MARGIE HOWES: He's hurting?
DARRYL CALVER: The big fella can't get up. You can't give up that's for sure.
(End of Excerpt)
(On Screen Text: Christmas day)
DEBORAH MASTERS: Its 7am on Christmas morning and nurse Julie Coughlin has just finished a 12 hour shift. She is updating the staff on what happened throughout the night and whether John Peart will be home for Christmas.
(Excerpt of footage of nurses talking)
JULIE COUGHLIN, PALLIATIVE CARE NURSE: He thinks he's going home today.
NURSE: Is he?
JULIE COUGHLIN: No. Oh yeah and then I brought in my Santa present, I did a Santa round, he was awake, "Oh I never got you anything" he said.
(Everyone laughs)
(End of Excerpt)
REECE PEART: On Christmas day there were people there, they, the nurses all paid for gifts for the patients and Dad got his panda and he named it Puff. Every time you go in there he says don't touch Puff or something.
(John plays with panda pushing it at camera growling)
DEBORAH MASTERS: Sandy Riches didn't spend Christmas at home either. The cancer has returned and this time it's in her bones.
SANDY RICHES: I'm just so mad at this damn thing, you know like I feel like saying you were around 14 years ago, go away somewhere else. I was in a nice little holding pattern and that nice little holding pattern seems to be changing and it's growing in my bones now.
DEBORAH MASTERS: Sandy will have five days of radiotherapy in an attempt to keep the cancer at bay and medication to control the pain.
SANDY RICHES: The pain is a damn nuisance and there's no point in saying "oh, it's not bad". It is bad, it's damn painful. Once the pain's gone you're right. You know, you can get up and do things. You can walk, you can ride bikes and all that sort of stuff which I will do once it, once they've harnessed this retched pain.
DEBORAH MASTERS: As 2009 comes to a close Darryl Calver's journey is also ending.
MARGIE HOWES: Last night when I was here he was very agitated, his breathing was getting difficult, our communication between each other wasn't, we couldn't, I couldn't quite understand what he wanted me to do and he was getting a little bit agitated with that.
THERESE COMPTON: It's just a restlessness that happens towards the end. It can happen and it's just you know, the body starting to shut down, and there's just a restlessness will settle in.
DEBORAH MASTERS: Just a month earlier Darryl believed he had 18 months to live. At 8.30am on New Year's Eve Darryl Calver died.
(Excerpt of footage of Darryl Calver in his bed and his family)
MARGIE HOWES: (Kisses Darryl) You're at peace now aren't you, no more suffering.
(End of Excerpt)
MARGIE HOWES: He was breathing quite shallow for the hours that I was here with him and then it just slowed, just to a normal breath and yeah, he went peacefully.
LOUISE EVANS: A lot of people have the perception that once a patient has passed away then it's just their body. But to me they're still my patient and they are treated with the utmost respect, I will still speak to them as if they were still with me in that room. I'll still tell them exactly what I'm doing because I couldn't bear to leave a loved one of mine on their own.
DEBORAH MASTERS: Sandy Riches is now well enough to go home. Sacred Heart's Occupational Therapist Alex Sydney-Jones and physiotherapist Jess Aitken accompany her. Their job is to ensure Sandy and John can manage.
(Excerpt of footage of Sandy Riches in her home)
ALEX SYDNEY-JONES, SACRED HEART OCCUPATIONAL THERAPIST: So we're going to roll you onto your side first, that's the best way to do it.
JESS AITKIN, PHYSIOTHERAPIST: This leg straight for me. So the opposite leg you're going to bend up and then you're going to roll. One, two, three, over onto your side.
ALEX SYDNEY-JONES: So you're just holding onto her hips and her knees, and that will help her roll and that's the first step.
JOHN RICHES: Yep.
JESS AITKIN: Next step Sandy...
(End of Excerpt)
DEBORAH MASTERS: Sandy will soon face another unnerving round of scans and blood tests. But for now she will make the most of being at home.
(Excerpt continued)
SANDY RICHES: I'm going to sloth about and drink tea and, oh I just want to revel in being home.
REPORTER: John, what's it like having Sandy home?
JOHN RICHES: Oh it's wonderful, it's, you're busy but when Sandy's not here because you're up and back from the hospital, the place isn't the same, it's just like a building, it's not a home, but it is now.
SANDY RICHES: Isn't he lovely.
(End of Excerpt)
DEBORAH MASTERS: Back at Sacred Heart John Peart is drifting in and out of consciousness.
NURSE MARCELLA: Would you like a little drink John? Try a little drink just before I go. Try and swallow that back for me John.
DEBORAH MASTERS: By Friday the 15th of January John Peart shows signs of being close to death. He develops a delirium - a symptom of his advancing disease.
DR KATHERINE CLARK: The difference is John has progressed over the last week, John has become, had become more and more confused and I think John has had a delirium for the last week and that's a very, very common scenario towards the end of life.
DEBORAH MASTERS: John is given anti-psychotic medication to settle him.
KAY PEART: Yesterday he could say a few words, but you know, just sort of under his breath, and he was talking to us.
REECE PEART: Yeah, he said bye to you.
KAY PEART: Yeah, he couldn't sort of say though that he was in pain, but just, like all of a sudden he'd come out with something.
REPORTER: He said goodbye?
KAY PEART: Yeah, and his lips moved like he was kissing me (crying).
DEBORAH MASTERS: Against the odds John lived for another four days. On the 19th of January at 1.30 in the afternoon John Peart died.
(Excerpt of footage of Dr Richard Chye doing rounds with junior doctors)
DEBORAH MASTERS: Dr Chye is on his rounds once more. The junior doctors with him are learning how to care for the dying. The harsh reality is palliative care specialists are in short supply. If Dr Chye has his way care will become as important as cure.
RICHARD CHYE: Having young doctors understand palliative care and then to take that learning, that understanding back into the main hospital to hopefully change that hospital's culture that palliative care is not all that bad. It's only a small step in terms of trying to change a whole generation of doctors, but that's where we feel we need to start.