Martin Young
Martin Young

Spare a thought for Madiba’s doctors and nurses

If I had to choose the way I could die, I would probably like to go peacefully in my sleep. It seems that Nelson Mandela no longer has that option. He may have had, and perhaps even been on that trajectory when he was rushed to hospital in the middle of the night more than two weeks ago. It would not have been a bad ending for any normal but frail 94-year-old.

Madiba may be old and frail, but in no sense of the word is he normal. A normal 94-year-old would not be exposed to the intense scrutiny of a world hoping to see its most famous statesman, and now its most famous patient, recover.

And for this reason, Madiba’s medical team must be under intense pressure. There are hopes that Madiba will recover, but based on the little public information available, there is not a doctor I know who I have spoken to that expects him to. The odds are heavily against it. Madiba’s recovery would be a miracle.

There are good reasons for keeping people alive on machines beyond the point they are expected to recover, and most of these centre around the family, so that family members living far away can come and see the person while still alive and say their last goodbyes. We can expect that that has already happened.

Another reason for an unusual patient like Madiba to be kept alive would be the fears of economic turmoil, race wars, violence, that some alarmists have voiced. I believe we as a country are beyond that, but the medical team must be aware of them.

Another reason would be for the political elite to have their last opportunity with the old man.

All these reasons, valid or not, create pressure on the medical team. Madiba is being treated as a “special” patient, of that I have no doubt. This itself raises the ethical question of whether one life is more valuable than another. It is part of a doctor’s responsibility to say, think and feel “No” under all circumstances. So why would Madiba be exposed to treatment options that would be heavily discounted or even frowned upon in other patients of the same age and health? Pressure, pressure, pressure from an outside world that is unable to let go, that does not want to see him die.

There is a good reason doctors should not treat their own family members. Some decisions are best made from an emotionally detached perspective. They are difficult ones, often having to choose the lesser of two evils. So any decision made around Madiba in this state of health must be doubly difficult, because no one can really be emotionally uninvolved. There would be a medical team of different doctors and nurses, having to argue and deliberate, knowing their decisions will be under scrutiny for a long time, made largely but not only for a family known to be fractious, controversial and attention-seeking, but also for a global public who have interests of their own.

The scrutiny goes beyond the decision-making processes. In a media and news-hungry world, it must be obvious that any information or, heaven help us, imagery carries enormous, albeit illicit, value. So the medical care must be given under unusually tight security.

I have no doubt that this is a very difficult time for all the medical team. For Madiba is “family” to every thinking South African. For many in the team this will be a career-defining moment, and their views looking back will be determined on how “well” it turns out.

I personally don’t see it turning out “well” in a sense that Madiba leaves hospital. “Well” in my opinion would be knowing Madiba is comfortable and is not suffering, and that he does go peacefully unaware of his difficult surroundings, even under these circumstances. I really hope I’m wrong, and that he does come through this, but reason and experience suggest otherwise.

These circumstances however suggest that at some point in time someone may have to say enough is enough and make the decision to withdraw treatment. That means someone will have to do the final thing that sees Nelson Mandela go the way of all men and women, and keep an entirely normal date with destiny. Someone at some point in time may have to switch off the machines.

I cannot imagine being that person, nor being part of the team that makes the decision, which will see the world’s greatest statesman and global icon on his way. How would that feel?

And that is why Madiba’s doctors, nurses, physiotherapists and other medical team members also need both our thoughts and prayers.

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    • Tofolux

      Despite all these speculations, I am still finding it difficult to deal with the impending loss. Please stop.

    • Pingback: Obama: My thoughts are with Madiba – Mail & Guardian Online | Internet News 247()


      I think TATA MADIBA is right when he says” if he had to choose the way he could die, he would probably like to go peacefully in his sleep” is true he can’t say those words again because he already said what was in his mind about his health condition, and I’m happy to read what he said to let you all be aware of ‘GOD’S WILL’. TATA has passion for Lord:Psalm42;1.Let GOD be with him to recover because to be in ICU is not child’s play I feel sorry even though they say miracles cannot happen but we must not loose hope let’s keep on praying for him. We also pray for all doctors ,nurses and medical team members helping him with treatment
      to not give up in good work your doing keep it up because you are good example of the nation. I wish all nurses and doctors could do what you are doing to TATA.

    • Call for Honesty

      Perhaps Mandela needs to be taken to one of the hospices in Pretoria where he can die quietly because neither his home or a private hospital will be a very quiet place. I can recommend Sungardens Hospice as one of the best.

    • bernpm

      I have the positive memory of my parents dying in peace and in their own bed and with some loving family members around them.
      My father at 77 and my mother at 94.

      My two sister were with my mother when she came back from a night in hospital with heart problems. She was in bed, recited a children poem as we all remembered from when we were young and when finished she closed her eyes and was gone.

      We arranged the funeral service around this little children poem. All people present were touched and happy in a way: she went without suffering leaving us behind with good memory.

      I cannot believe the circus around Mandela as allowed by his immediate family. Disgusting!

    • Joseph (UK)

      A few weeks ago Nelson Mandela praised and thanked his doctors and said something about prayers not having any power to heal. He said people who are ill should instead go to hospitals. Could someone please share the link to a report about his exact words about that.

    • So sad

      I have had to make that call- and my own child was involved. Something happens in that situation. It is a knowing – a deep seated and instinctive understanding that to continue with treatment is wrong. It has to do with facing your own fears of death and your ability to ease the passing of your loved one. It has to do with understanding ultimately, that death is the very natural and normal conclusion of life, and that the pain that is associated with it is a testament to our humanity and the fact that we are able to love and live in deep and meaningful relationship with others. Most of us have no idea of how strong we are, because to a large extent, our lives are lived very superfically on a day-to-day basis. We are seldom “tested” to such extreme degrees. Knowing you have made the right choice is hugely empowering and maturing. I have no regrets whatsoever. My child died two hours after I told medical staff to stop treatment. Quietly, and with great dignity – and pain free. My wish for the Mandela family and for our beloved elder, is that they will be given all the strength that they need at this time, to ensure that he too will keep his dignity at the end of this very human life cycle.

    • Levy Mokgadi

      True that. I think the can do everything to the best of their ability and more than that… It’s inthe hands of the almighty God. Wharever the outcome- Thank you TATA, we are and we will forever be grateful for your secrifice of a better nation.

    • http://none Lyndall Beddy

      Turning out “well” in my opinion is if Mandela is well enough for Obama to visit him, however briefly. Obama can go to Robben Island any other time, and is likely to spend a lot of time in Africa once his presidential term is over.

      Mandela’s slight improvement seems more likely to me to be the reassurance that family, elders, and the courts have upheld his wishes for family remains to be returned to Qunu, which seems to have been praying on his mind.

    • Brian B

      Madiba deserves the best available treatment.

      Despite the rigors of prison life and the stresses and strains of his efforts to unite South Africa at an age where most people have retired, some are frail and some already have died, he has displayed amazing tenacity and fortitude.

      It is remarkable that he has reached his nineties .

      When the time is right he will move on to a higher plain .

      The hospital staff will remember with great pride that they had the privilege to treat a singularly unselfish wise and compassionate icon.

    • http://none Lyndall Beddy

      When my mother was on life support and in intensive care, visitors including family were severely restricted. I was, in fact, the only one allowed to visit. The doctors explained that family are the most normal cause of stress for patients which is why their access is restricted. The constant stream of family visiting Mandela this past month I found surprising. My mother, however, recovered. Maybe the medical rules are different if the patient is terminal?

      I just find it unlikely that Mandela’s daughters would be suing Mandla; or Zuma would fire Tokyo Sexwale who is one of Mandela’s trustees with Bizos, if they thought that Mandela would recover to dispute their actions.

    • Mokone

      Eish i fell sorry for Mr Mandela and i wish the grace of the living God will always be with him.Hope African leaders could follow his steps Onkemetse Mokone from Botswana