Hektoen International

A Journal of Medical Humanities

Death from uremia

“Your grandmother is doomed,” [the doctor] said to me. “It is a stroke brought on by uremia. In itself, uremia is not necessarily fatal, but this case seems to me hopeless. I need not tell you that I hope I am mistaken.”

[Then] there was a moment when the uremic trouble affected her eyes. For some days she could not see at all. Her eyes were not at all like those of a blind person, but remained just the same as before. And I gathered that she could see nothing only from the strangeness of a certain smile of welcome which she assumed the moment one opened the door… Then her sight was completely restored, and from her eyes the wandering affliction passed to her ears. For several days my grandmother was deaf…. the impediment in her speech increased…and realizing that we could no longer understand her, gave up altogether the attempt to speak and lay perfectly still…

Then came a state of perpetual agitation. She was incessantly trying to get up. But we restrained her so far as we could from doing so… One day when she had been left alone for a moment, I found her out of bed, standing in her nightdress trying to open the window. We were just in time to catch her; she put up an almost savage resistance to my mother, then, overpowered, seated forcibly in an armchair, she ceased to will, to regret, her face resumed its impassivity. The look in her eyes changed completely, often uneasy, plaintive, haggard, it was no longer the look we knew, it was the sullen expression of a senile old woman.

I bent over to kiss that beloved forehead…. she looked up at me with a puzzled distrustful, shocked opinion: she had not recognized me. The doctor said this was a sign that the congestion of her brain was increasing. It must be relieved in some way. Without much hope he prescribed leeches. When a few hours later I went into my grandmother’s room, fastened to her neck, her temples, her ears, the tiny black reptiles were rising among the bloodstained locks as on the head of a Medusa….

Alas! No sooner had the leeches been removed that the congestion returned and grew steadily worse… We went to the sickroom. Bent in a semi- circle on the bed, a creature other than my grandmother, a sort of beast that had put on her hair and crouched among the bedclothes, lay panting, groaning, making the blankets heave with its convulsions…The doctor gave her an injection of morphine, and to make breathing less painful ordered cylinders of oxygen…

Then it seemed that all was over; the breath stopped….The doctor stooped to feel her pulse… Then suddenly she half froze, made a violent effort, like someone struggling to resist an attempt of her life…. She opened her eyes; the hiss of oxygen ceased; the doctor moved away from the bedside. My grandmother was dead.

Marcel Proust, Remembrance of Things Past: The Guermantes Way

 


 

Sections  |  Nephrology & Hypertension

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