Let’s talk about something we don’t talk about enough — recognizing when someone is truly reaching the end of life. It’s not always dramatic. No slow violin music, no Hollywood-style monologue. Often, it’s subtle, silent, and seen only by those who are looking for it.
I still remember a COPD patient from Ziarat, quietly sitting in the ward chair, too breathless to talk, too tired to care. His vitals didn’t scream emergency, but his entire demeanor whispered “I’m done.”
🧠 Mnemonic: “Inert People Breathe Slowly”
| Mnemonic | Clinical Feature |
|---|---|
| Inert | Infections — recurrent or non-healing ulcers, pressure sores, chest infections |
| People | Progressive weight loss — unintentional loss >10% over the past 6 months |
| Breathe | Breathlessness — MRC scale 4/5 or dyspnoea at rest/minimal exertion |
| Slowly | Self-care decline — bed or chair-bound >50% of day, disinterested in food, hygiene, etc. |
At Sheikh Khalifa Hospital, Quetta, I’ve had the privilege to learn this the hard way — in CCU, Gastro wards, and during palliative consults with Dr. Basit Khan.
We can’t always prolong life. But we can avoid prolonging suffering. That’s where recognition beats reaction.
So next time your patient looks “inert” and is “breathing slowly” — stop, think, and maybe switch from escalation to comfort.
Happy learning! 🙂
Discover more from Bibliobazar Digi Books
Subscribe to get the latest posts sent to your email.
