A Blue Sky

Following weekly engagement in a primary care module at university, I decided to explore the theme of ‘End of Life’.

Written in the perspective of an elderly male approaching the end of his life, this poem details the reality and complexity of death, from the emotions experienced to the unique needs of an individual. My inspiration for this piece stemmed from not having grown up with either of my grandparents to the sudden realisation that somewhere in a foreign village, my elderly grandma was having to face the difficulties of covid-19 on her own. I have only ever heard her voice, but I worried for a face I don’t know, longed for an embrace I’ve never had and hurt for a woman whose loneliness is concealed by her strength. In writing this poem, I wanted to truly consider what someone in her position, someone vulnerable to death, thinks, feels and wants.

The poem opens with the persona saying he feels “like a paper boat”, a metaphor I feel encompasses the fragile nature of life when your days are numbered. There is an almost youthful hope that the “paper boat” will travel far, followed by the inevitability of its journey coming to an end, and through this stanza, I had to challenge my understanding of end of life care. When considering the definition for end of life, I realised I only thought about elderly members of our community, when this reality can also unfortunately be true for children and young adults, allowing me to redefine what end of life care means to me. This gave me the opportunity to further appreciate the nuances of life, how intricate we as people are and the difficult role a health professional has in accounting for our differences and our individual wishes. Where a patient in their nineties won’t be considering having children, a young woman with terminal cancer may have been and I was able to value the professional and coordinated level of care that is needed, especially towards the end of life.

The poem further delves into feelings of longing for familiarity, love, guilt and hope. I realised the importance of the little things such as being in the comfort of your own bed, surrounded by your usual smells, the sights of your possessions dotted around the room, the sound of music, Qur’an, hymns, the presence of family, religious figures and chosen health professionals. It highlighted to me the level of autonomy we have, even in death and the significance of passing with dignity and with our desires met, a privilege that isn’t shared in all corners of the world.

Ultimately, the poem intends to reflect on what it means to be human even in the face of death and whilst it is written in the patient’s perspective, I believe it encourages all readers, from healthcare professionals to young people to consider mortality through a very raw and real lens.

Shakira Irfan (Medical Student, St George's University of London)