That morning, an encounter, that will long be seared into the wrinkling folds of my brain.  I was running late, knowing they would be waiting.  A teenager and his family, cared for by our team over the past weeks, my nurse, already sitting with them.  I was alerted to things being not quite right by a warning shot from the ward sister: – “he looks terrible today”.  The consultant whom I knew well, who had referred him to our team, shrugged exasperatedly, greeting me briefly.  My sensors were thrown wide open.  I had already expected some of this.  I knew that they might have run low on pain meds over the weekend, as I had received an email.  My offer for the necessary prescription to be collected had been rebuffed.  But prepared, I was not.  Not at all!  Not prepared for that which met me as I walked into the consultation room and the instantaneous anger that arose.

It took me only a few short moments to understand what was present. My response was instant, was livid.  It must have briefly shown on my face, and in my body language  (never having been very good at my masks when faced with the suffering of children).  The parents themselves blanched, not quite knowing where to look, my nurse, relatively new to the team, was close to tears with distress as she felt the enormity of what was present.  To give time to settle, time to become fully present to myself and to everyone in the room with care and compassion, to compose myself having voiced my disbelief and displeasure at the evidence of a young person in terrible pain, to settle the unexpected tears I heard creep into my barely suppressed shaking voice, I paid attention to and settled in with the littlest ones in the room.  The younger siblings I had asked the parents to bring to this next consultation so we could talk together about how they were managing the impending death of their brother.  Giving me, and all of us, some time for a gathering of ourselves, time to figure out how we all got here, to this painful, terrible, colour of grey.

The colour of pain that day was all absorbingly, unnecessarily, terrifyingly still and grey.  Hanging on by the fingertips grey, frail body squared against pain grey, eyes sunken into fine folds of anguish grey, completely consuming the atmosphere in a room bursting with not wanting to see.  So I did the only thing I could at that moment.  I shooed everyone, bar the one with the grey pain, out the room and started back at the beginning again.  Pain control now, and plan again for the days ahead. Find out what more was needed and ensure an adequate plan for care.  Meet one by one and together with each and everyone who showed up that day.  Usually my consultations are fairly flexible, with much meandering around of discussions.  My team has the privilege of time.  Livid, however, demands of me to be more decisive and directed.  It’s not an emotion commonly felt, but one that alerts to this being a watershed moment of how to show up, the importance of a particular issue at hand.  This time it alerted to advocacy around adequate pain control, advocacy around improved understanding, caring for and managing the dying process for a young teen, advocacy for a son who would subsume his own needs to ensure family harmony.  Livid slowly settled, and enabled traumatic skeletons to be revealed by a complicated and secretive family.  A family in need of deep care and listening, with a life journey to be normalised, facing the death of a child in the only way they knew how.  A family, who every day, is living the colour of pain grey.