Friday, September 9, 2022

Passing On : The Queen.......

I was in the Doctors' Common Room just yesterday at Subang Jaya Medical Centre. Queen Elizabeth the 2nd's death was still playing in my mind despite a busy morning clinic. Death somehow always make me ponder. And the Queen is not any ordinary folk. She has been the bedrock of the British monarchy for more than 70 years. Never controversial like some clowns down south here somewhere.
 
Regal, and not overbearing and for 70 years of Britsh history, not Malaysian history. That by any Malaysian standard, is a record. Ours , inslots of every 5 short years, usually fails miserably.

My colleugue and old time medical classmate of mine, senior paediatrics consultant oncologist, thought loudly that Queen E's physicians attending to her at Balmoral Castle must "let her off " easily, gracefully and gently into the next phase of existence. 

 " No lah Lee Lee,....... given the scenario that just 28 hours earlier Queen E was able to see and greet the new incoming PM at Balmoral, I dont think that Queen E, went on that just like that easily.It must be one of two things...Either she had a sudden cardiac event, like a cardiac arrest culminating, in a sudden cardiac standstill or ventricular cardiac arrest or a major cerebral event like a sudden stroke, more likely the former....the "our Queen is now in a state of serious illness" drama on TV, giving a breathing space of say 12 hours is just 'royal wayang kulit' for public  and news consumption......A fine very royal PR job, to keep the populous ready to accept the impending demise of a very much loved monarch!" 

" Or, following the catastrophic event,  she barely lingers on, on full cardiac and ventilatory support....It is pretty unlikely though because if that is the case, she would not be managed in Balmoral. They can but it is hihgly unlikely. She would be very quickly transported to any centre of excellence in Edinburgy or even London.....Definitely very unlikely that she has an unresolving pneumonia..Otherwise she would not be able to attent to the new PM a day earlier." 

 " The decision to keep and manage her in Balmoral Casttle , if she still lingers on rather than transfer her to say a top medical centre or tertiary centre in Edinburgh was a fine line though which speaks volumes of the level of finese and wisdom of the Royal Family of Britain in dealing with this kind of family emergency. 

 "I am very sure if I am the one managing her , as the sudden event took place , she will be rightaway transferred to the Medical Facility within the Castle..It is not unexpected that in the UK , with a 96 year old Head of State around, they dont have ICU facilities within Balmoral ,or Windsor. It is not Britiah to not have these.... " 

"I would have started her on triple or quadruple inotropes [ heart pumping intravenous medications ] intravenously, hoping for her vital signs such blood pressure and respiration to pick up. I am pretty sure at some point when vital signs seemed dire and dicey a decision to intubate her and sustain her temporarily would be on the card. If her son , Prince Charles was around, this would have to be discussed with him. Such procedure in a way would give some time for the other close royals to arrive and percolate fast from any where from England to Balmoral....Given that she had been on intravenous triple ot quadriple inotropes, plus minus artifuicial ventilation, and her vital signs does not pick up measureably, this would give the royals time to gather and ponder over my next action." 

 " Vital signs not coming up, Bp hovering in the low systolic 40's, fundal examination showing feable reaction to light I would then bring on Prince Charles aside and tell him........Your Highness, In my considered opinion, it is futile to go on...I think Madame Queen is not coming back......" With his permission, upon general agreement with all his siblings and close royals, Prince Charles would have agreed to the game plan: slowly slowly start tailing down all the inotropes, and subsequently even off the ventilator , if upon taking off all the inotropes, Queen E was still hanging on. That constitute a gentle, graceful exit for a monarh of 70 years. Death would have followed shortly aftwer that".

If I am a betting man though, I would bet that the Queen had sudden cardiac death, and all the BBC and CCN and al Jazera dramas for a good 12 hours at least were just a good PR exercise, preparing for a Commonwealth of Nations and the world at large to come and accept the inevitable.

Inna Lillah Hiwainna Ilai Hirojion
From HIM we come , to HIM we return

I love King Charles the 3rd very much. I have been following him over much of my adult life over 50 or so years. ..He is just 3 years my senior...I pity him sometime because he bear the brunt of oftentimes, biased and unfriendly press for decades.
His late Mom was spared of this because she did not have to undergo any apprenticeship at all.!

King Charles the 3rd will be a great king!
He will probably surpass Queen E.
In this current troubled planet, King Charles the 3rd would represent a breath of fresh air.....

Mark my words.






OTHER ARTICLES ON DEATH & DYING :

http://drnikisahak.blogspot.com/2017/10/kassim-ahmad-in-memorium.html


http://drnikisahak.blogspot.com/2017/01/just-visiting-part-2.html


http://drnikisahak.blogspot.com/2009/01/pearls-gem-redza.html


http://drnikisahak.blogspot.com/2015/10/truncated-lives.html


http://drnikisahak.blogspot.com/2008/07/not-so-pearls-gem-kaffarah.html