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BMJ. 2007 August 25; 335(7616): 379.
PMCID: PMC1952492

Buying cake is our job

Yolanda S Augustin, senior house officer in palliative medicine, London

I cried at work yesterday, for the first time in ages. Don't know why—it was probably a culmination of a number of small things, but I'd been spending the whole day running around trying to clerk patients, place cannulas, replace blocked suprapubic catheters, chase blood results, liaise with oncologists, break bad news, and talk to relatives. I should know by now that medicine is stressful and you need to multitask.

On the ward round that morning we'd seen a man with cancer who had come to us for symptom control, but it now looked as though this could become a terminal admission. We'd told him we were concerned that he was becoming weaker. He told us he still believed that God had a miracle for him. As we left his bedside he called out after us, “My daughter is coming to visit me later. It's her birthday today.” He was beaming with delight.

I asked for help to sort out a surprise birthday cake. The ward clerk tried her best and made telephone calls to the domestic and volunteer department, without any luck. Everyone was busy. I went off to see another patient; the ward was particularly hectic that afternoon, and staff were flying around trying to complete various jobs. I was about to try to get a cake myself, but then another patient needed to be seen. I asked again to find someone who could go. “This man is dying,” I said, “This is the last of his child's birthdays he will see. Let's not let this opportunity for something special pass by. Can one of the ward staff go, maybe?”

The reply, not meant to sound unthinking, was, “It's not our job to buy cake.”

No, it's no one's “job” to buy cake. “But you're wrong,” I thought, “It is our job . . . it's our job to try and make people happy, surely.”

And now for the happier part—and this is why I love palliative care, because it really can bring out the best in people. I called my consultant, meaning to say that I was bogged down with work and wouldn't make it to the afternoon journal club. I ended up crying instead. “Hang on,” she said, “I'm coming over.” Ten minutes later she appeared on the ward, chaplain and director of mission by her side, smiling broadly. A pretty paper bag, cuddly soft toy, sweets . . . birthday cake and candles that later appeared out of nowhere (bought by one of the nurses as she went off duty) . . . a special birthday song by the father's bedside . . . smiles, laughter, a glimpse of hope, of what it's like to be normal again.

“Yes,” I thought, “Buying cake is our job.” Perish the day we forget that, for we lose a part of what it is that makes us human.


Articles from The BMJ are provided here courtesy of BMJ Publishing Group