Chapter 14: Ornanong

Pip...pip...

The blue-coated nurse looked at the pulse monitor of Mr. Krishna, a 92-year-old man, who has been in this ICU for more than a month. Last month he was found unconscious on the kitchen floor. His son quickly called 1669 and was rushed to the hospital. A CT scan showed that blood vessels in his brain had ruptured. After a craniotomy to remove the blood clot and prolonged use of a ventilator, the patient has not yet regained consciousness and probably never will.

At this time, Krishna is battling sepsis that shows no signs of improving. His organs begin to fail one by one. To be honest, the patient should have already died, but the life support and blood pressure-raising drugs prescribed by the doctor slow him down. Ornanong tried to tell the patient's daughter and son, but they were angry with her and thought Ornanong was cursing her father to make things worse. They insisted that they would do everything possible to keep Krishna alive.

Ornanong has worked as a professional nurse for more than 20 years, and 10 years in SICU in particular. He often saw people who ended up bedridden and unconscious, whose families could no longer care for them and left them in the hospital. There have also been cases of patients whose bodies could not move forward, but their relatives could not accept their death and asked the hospital to do everything possible to keep them alive. When the medical staff was successful, the families refused to care for the patients and left them in a vegetative state unable to move forward. I also had to be the recipient of the emotions of family members and surgeons every day. What she had to face made Ornanong worried and that accumulated into stress. Ornanong's passion as a nurse had already died. His mind was focused on counting down to the day when he would have worked enough to be able to apply for early retirement and enjoy his pension. There are only a few years left.

The nurse placed the chart at the end of the bed and approached the patient's side of the bed. He held the hand wrinkled and bruised from the repeated venipunctures in his and said softly, "I know you're hurting." She said softly, "You must be in pain, but you can't leave because these things are holding you back." She looked at the life support equipment surrounding the bed. "These things have been given to you by other people when you didn't even make the decision yourself. Is this what you really want? No one can know now."

He moved his hands to adjust the patient's disheveled clothing. "What can I do for you?"

Suddenly, the curtains separating the beds opened, "Nong!" Mayuree, the junior nurse, poked her head out from behind the curtain and said. "Jitr urgently asked to see you in the principal's office."

"Jitr, the head nurse?" Ornanong raised an eyebrow in surprise.

"Yes, he just called." Mayuree came in and collected the patient's chart. "Nong, you should go. It sounded important. I'll take care of this for you."

Ornanong nodded in thanks. He took off his gloves and threw them in the trash. She went out to pick up the long blue dress and wore it over her medical gown before quickly leaving the SCIU.

There were three people on the couch in the hospital director's office. One of them was Dr. Somsak, the director, while the other two were Nurse Pleonjitr, the head nurse, and a handsome young man with good looks and skin. He was wearing a crimson shirt with a short robe over it. Ornanong didn't know this man, but with just one look, he could tell that he was a doctor. Her piercing eyes looked at Nong's face and the nurse could feel some kind of energy in him. It was an energy that stunned her for a few seconds. Not because he was incredibly handsome, but because I could sense that he was someone with a lot of charisma. Ornanong refocused and politely raised his hands in greeting before sitting down in an empty spot. It seemed that the atmosphere in the room was not too stressful.

"Sorry for calling you suddenly," was the first person to speak Pleonjitr. "Professor Somsak and I were talking about the plan to open a palliative care unit."

Ornanong widened his eyes and looked at Dr. Somsak with bright eyes. The plan to open the Palliative Care Unit had been discussed for many years. Ornanong herself had trained as a palliative care nurse for about four months and was now ready to work. What was missing was just an official team. "Really, Professor?" Somsak smiled and nodded. "We finally have a team leader." The doctor showed his hand to the stranger in front of him. "This is Dr. Gunn, the family doctor specializing in palliative care."

Dr. Gunn nodded and smiled slightly. When he smiled, he looked even more handsome.

"One of our difficulties is that the Ministry does not have a structure for palliative care for you, even when you are within the service plan." Pleonjitr sighed. Ornanong understood this issue well. While palliative care took on a more important role because the number of patients in the system was very high, the headquarters did not provide a framework for the hospitals, which affected the professional progress of staff. No wonder staff lacked motivation and no one wanted to work in palliative care. Only people with true passion could stay. "However, at this time, I spoke with your supervisor and she is more than happy to have your name in the room until there is a structure for you. Dr. Gunn's name will be in the Department of Social Medicine and he will cooperate with the medical groups. establish the Palliative Care Unit under the vision of the director to give more importance to this field of work.”

"Starting next month, Ornanong will be transferred to work in palliative care with Dr. Gunn," the director continued. "Dr. Gunn has already established the system for caring  terminally ill patients. Find time to study with him and I will help push our palliative care work beyond national standards."

Ornanong felt his heart fill with happiness. "Thank you, Professor Somsak, Jitr and Professor Gunn. I will work as a palliative care nurse to care for terminally ill patients to the best of my ability."

Pip...

The last pulse in Krishna's life sounded and fell silent forever. Ornanong turned to look at the tall Dr. Guntapat who was standing calmly by the bed. It is incredible that Guntapat was able to change the situation 180 degrees with his excellent speaking skills and made the patient's son and daughter accept their father's departure. Now they wanted their father to die peacefully and without life support equipment attached to him. Dr. Gunn made an appointment for the patient's family to meet one last time to say goodbye before taking the patient off the ventilator and life support equipment. Morphine and sedatives were administered so that the patient would not suffer. The image she was seeing in front of her brought tears to her eyes. She cared for this patient for a long time and today he looked bright and pain-free. He looked like someone who went to sleep and passed away peacefully.

"Dr. Gunn, is this considered euthanasia?" -Onanong asked.

The young doctor shook his head: "No, this is not euthanasia, but it is to allow the patient to die naturally." The doctor explained in a soft, deep and calm voice, urging the audience to stop and listen to his every word. "The doctor responsible for the patient and I evaluated this patient's symptoms and diagnosed that the patient has entered the last phase of his life. No matter what treatment we use on him, we cannot prevent his death, with or without life support. I spoke with the patient's family and they understood. They didn't want his father to be in this state anymore. The doctor paused for a moment: "But if the patient has not entered the last phase of life and I intentionally made him die faster, that is another story."

"Which is illegal, right?"

Gunn smiled slightly, "Definitely illegal."

"If the patient has not entered the last phase, but is sick with later stages of cancer. He is in enormous pain and asking for death, how would you help the patient?"

"I will first help you deal with the pain and then reassess it. The idea of death can disappear if the pain is managed well or if stress and depression are properly treated," the young doctor calmly explained.

"Nong, can you remember Aunt Samorn, who was sick with late-stage lung cancer? After I adjusted the morphine to a dose that could control the pain, she never said she wanted to die again."

Ornanong nodded to show that he understood: "I feel sorry for these patients every time I see them. Some of them took a long time to enter the last phase and had to remain in pain for many months, many of them for years. If I have to being sick knowing that about the future, I prefer to die sooner than later.

Gunn remained still and silent for a while: "We share the same thought." The doctor moved away from the bed and opened the curtain. "The patient passed away peacefully at 11:20 a.m."

It wasn't just this patient that Dr. Gunn was able to bring to a peaceful death. All of the cases Dr. Gunn saw achieved the results Ornanong expected, leading her to have increasing faith in Guntapat. Dr. Gunn was quickly able to reach palliative care milestones and open the palliative care clinic with home visits and telephone follow-up of each case until the last moment of the patients' lives. In just six months, Guntapat won the entire heart of Ornanong. This young doctor could help the patients he loves live the best final moments. I had no doubt about how Guntapat cared for patients. He would do anything to help Gunntapat take full care of the patients, including the special treatment he designed.

One afternoon, Ornanong approached Gunn with a harmless-looking pink plastic basket. The doctor looked at his nurse. The two of them didn't say anything to each other, but their eyes could communicate that what Ornanong brought him was something that will make his patient's treatment perfect and without any flaws.

That night, the 45-year-old male patient suffering from nasopharyngeal cancer, which had eaten away at his face until it became swollen and created excruciating pain, was the first patient specially treated by Dr. Guntapat.

Ornanong could still remember the feeling when he called to ask about this patient's symptoms. His wife took the call on his behalf and said the patient passed away peacefully last night. When his wife found his body in the morning, the patient's face was bright without any trace of pain. He slept with his hands on his chest as if he had just gone to sleep. The overflowing feeling of joy brought tears to his eyes. She didn't idolize the wrong person. Dr. Guntapat Akaramethi was the person who made him feel that working in the profession was so valuable. The passion that had been extinguished has been rekindled and is even stronger than when she first received her first nurse's hat.

"Dr. Somsak's symptoms are improving. He should be able to leave the ICU in a few days," Dr. Gunn said as they were alone in the room. Ornanong immediately had a bad expression on his face.

"Is Professor Somsak more awake? If so, will he be able to remember everything that happened?"

"I don't know either, but judging from his recovery trend, he should be gradually improving because his brain did not suffer any damage. If his body recovers well, he will be awake more often now."

"What should we do next, doctor?" the nurse asked anxiously. "If Professor Somsak really wakes up, it won't be good for you."

"Everything is fine," the doctor said calmly. "There is only one way left."

Ornanong was able to understand what Gunn wanted to do with a single sentence. "If you are doing that to Professor Somsak, we have to do it carefully." The nurse approached him and raised her hand to gently touch the doctor's shoulder. "Doctor, don't worry. I've worked in that building before. I know how to get the timing right. I can come up with a plan. I can make sure no one can catch us."

Gunn thought about it for a while. His expression was not so good. "But I have never killed anyone. What I have been doing is treating patients. If I did that to Professor Somsak, I would be murdering someone."

"You have to do it," Ornanong insisted firmly. "You can't let everything fall apart right now. This time you have the advantage. If you want to do it, you have to do it now. I will help you."

The young doctor seemed somewhat relieved. He turned to smile lightly at Ornanong, “Thank you, Nong.”

The elevator where Dr. Somsak was killed must be the elevator without CCTV.

And if there is an investigation into this, the person suspected of being Dr. Somsak's murderer must not be Dr. Guntapat.

This is simple, Ornanong just had to borrow someone else's identity.

"Hello," the nurse in the clean white uniform and white shoes walked over with a pink plastic basket in her arms. He went to greet the young orderly who was sitting resting in the Patient Transfer Unit. "Nui is not here?"

"Nui doesn't have an afternoon shift today," the young man answered innocently. He was a tall, muscular man and wore black-framed glasses. He also had wavy hair. "Is there anything I can help you with?"

"Oh, that's too bad. I was planning on bringing him my homemade juice to try." Ornanong held up the pretty colored basket for him to see. "I don't want to leave it until tomorrow. Can you help me drink it?"

The man hesitated a little, but still raised his hands in gratitude and accepted the bottle of Ornanong's fresh blended juice.

"What is your name?" Nong asked with a kind smile.

"My name is Tao," replied the young man.

"My name is Nong, nice to meet you." The nurse nodded towards the bottle of juice in Tao's hand and said, "Try it and tell me how it is so I can adjust the recipe."

(Del: Oh wow! So Tao was just in the wrong place)

Tao nodded and smiled thoughtfully before opening the bottle and drinking the juice. Ornanong stared at him with a smile. Tao drank the juice for a while and then frowned. He choked a little. "It's a little bitter, but it's still tasty."

"Oh, no," Nong exclaimed and covered her mouth with her hand. She seemed alarmed. "I suspect it's the orange or lime peel that fell into the juice. Sorry, I'll adjust the recipe tomorrow. Anyway, do you have some free time now, Tao? Can I ask you to help me carry some things under building eleven to the car for me? They are the donations that people donated to my Palliative Care Unit. I can't carry them alone."

"I have some free time." The young man stood up immediately. "Are there a lot of things? In case I need to call other people to help me."

"It's okay. Just you will be enough." Ornanong smiled sweetly. "I'll bring the car to pick you up."

"Surgical Intensive Care Unit, this is Mayuree."

"Mayuree, this is Ornanong," Ornanong spoke into his mobile phone as he stood over Tao's unconscious body with bottles of alcohol next to him. At first glance, it looked like he had gotten drunk and slept on the street behind building eleven, which was the back building and was quite isolated, dark, and had no security system. The nurse kept the syringe attached to a needle in her bag. Ornanong already expected that the anesthetic mixed with the juice would not be enough for this tall young man, so he brought some injectable sedatives with him.

"Yes, Nong. Is there anything I can help you with?" Mayuree responded happily.

"Dr. Guntapat asked me to ask you whether Dr. Somsak will be moved out of the ICU today or not. He wants to check Dr. Somsak's symptoms tomorrow and wants to know which building he needs to go to."

"You called at the right time. I'm about to make a call to the General Room to make the transfer and ask Oui to call and inform the police."

"Oh, so you're going to ask for a stretcher, right?"

"Yes, you can tell the handsome doctor that he doesn't have to walk so far here anymore." Mayuree suddenly became curious about something, "By the way, why does your Dr. Gunn want to visit Dr. Somsak? They almost killed each other."

"Maybe you want to know your symptoms. It's curious as a doctor," Nong laughed a little. "Thank you very much, Mayuree."

"You're welcome, Nong." And then Mayuree hung up.

After that, Ornanong called Dr. Gunn: "Doctor, they are about to call the stretcher staff on duty. You can prepare now."