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Tag: end of life decision making

Return of the Hero

Peg Ackerman May 24, 2013 1 Comment

Peg Ackerman

Blanched by anemia, Mary rested quietly in the hospital bed. Her pallor made her barely visible amid the bleached bed linens–she seemed a mere shock of white hair against the pillowcase. 

Age ninety-three, she’d visited the hospital a half-dozen times in as many months, shuttling between nursing home and hospital as many elders unwittingly do in their last year of life. She may have preferred to stay put, but no one knew for sure: as a person with dementia, she was presumably unable to speak for herself. 

I was a palliative-care nurse practitioner in the hospital. Until about two decades ago, whenever someone neared the end of life the details of care were discussed with his or her doctor; nowadays, that intimate discussion often

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Note to My Patient

Sarah Stumbar January 11, 2013 No Comments

You might be surprised to know that I’m lying here in bed still thinking of you two weeks after you’ve died.

During the month that I watched you die, I often wondered what it felt like to be you, with your deep, husky voice, rounded belly and stubborn anger. You’d once owned your own mechanic shop; now you were sitting here in a hospital bed, staring up at the medical team as we whirled in and out of your room. Staring up at me as I drew blood from your central line each morning.

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Code Blue

Stephen W. Leslie November 30, 2012 3 Comments

Stephen W. Leslie

I was startled awake at 3:40 am by a loudspeaker blaring “Code Blue…Code Blue.” 

As the hospital’s newly hired chaplain intern, I’d been sleeping in the overnight room. Stumbling out of bed and groggily changing out of my pajamas, I made sure to put on my hospital badge. 

I made my way to the hospital’s “Z” building, where the ICU was located, and took the elevator to the fourth floor. The elevator opened onto a row of doorways, each decorated with a red warning sign: “Stop! Do Not Enter. Authorized Staff Only.”

I picked one and went through. 

I’d guessed right: At the far end of a hallway, a group of gowned nurses swarmed around a woman lying in a hospital bed,

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What About Bob?

Joseph Fennelly June 22, 2012 No Comments

Joseph Fennelly

The time: early one morning, thirty years ago.

The place: my local hospital.

At this point, I have been an internist for twenty years. I’ve just entered the cardiac care unit, where my patient Bob, a ninety-five-year-old man with advanced senility, has been brought because he’s having chest pain. 

As I step through the door, Bob codes. The young residents and staff swing into action, rushing the crash cart over to his bed.

Quickly, I jump between them and Bob. 

“Don’t resuscitate him!” I shout.

Looking stunned, they eye me as I stand there with folded arms, making myself into a human shield.

Bob lies motionless, not

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Cold Comfort

Mary T. Shannon June 15, 2012 No Comments

Mary T. Shannon

Leaning against the hospital bed’s cold metal rails, I gazed down at my husband lying flat on his back. Under the harsh fluorescent ceiling lights, his olive skin looked almost as pale as mine. 

We’d been in the outpatient unit since 6:00 am for what was supposedly a simple procedure–a right-heart catheterization to assess the blood pressure in John’s pulmonary arteries. Now it was 3:00 in the afternoon. 

Before we’d arrived that morning, John had seen the procedure as a chance to take a day off from the clinic where he practices internal medicine.

“I think I’ll go out this afternoon and hit a bucket of

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Out of This World

Katelyn Mohrbacher March 30, 2012 No Comments

Katelyn Mohrbacher

When I met Jasper, I was a third-year medical student doing a nine-month rural clerkship, and he was an eighty-year-old man in a coma.

Family members surrounded Jasper–a tall, broad-shouldered man–as he lay in the hospital bed. His wife, Esther, a petite, lively woman also in her eighties, stood by his head, grasping the bed rail. At the foot of the bed stood their son, a middle-aged man with a baseball cap on his head, his hands fisted in his pockets. Flanking the bed were his sisters (both nurses), one with curly hair and a baggy sweatshirt, the other slim and well-groomed. A warm summer breeze wafted through the room, bringing the scent of fresh-cut grass.

Jasper had been admitted two days

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Fifty Minutes

Elizabeth Tyson-Smith February 17, 2012 No Comments

Elizabeth Tyson-Smith

“I know it will kill me,” my patient Jan says calmly. 

We sit in my office looking out on the river below, which glints in the fall sunshine. It is a warm day for November. Jan has just learned that her breast cancer has spread to more internal organs. 

Her doctors have told her that she will not recover.

I–who have had breast cancer twice–cringe inside. Jan’s blue eyes fix on mine, but she expresses no emotion at all. 

In 1990 a routine mammogram showed a bright white constellation in my breast. The biopsy was positive. I heard four words: “You have breast cancer.” I was forty-eight;

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Heroic Measures

Gil Beall December 30, 2011 No Comments

Gil Beall

“Doctor! Doctor! He’s stopped breathing!” the stout woman shouted, clutching at my white coat. 

It was 1953, and I was a first-year resident responsible that night for the patients on the medical ward–including those in the four-bed room the woman pushed me into. 

There I saw a melee taking place around a seventy-year-old man with chronic lung disease. 

The man had been examined and admitted that evening by my colleague, who’d given me what little information he had before leaving for the night. 

The man had been too absorbed in his breathing to talk much. We’d hooked him up to an oxygen tank and started an intravenous infusion of the bronchodilator aminophylline, which brought about modest improvement. We couldn’t think of anything else

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Enduring Guardianship

Sue Ogle September 9, 2011 No Comments

Sue Ogle

I was cool on the way to the lawyer, we’d talked it all through, no problem.

So why am I remembering the old kauri house where the wiring was dodgy
and I held my breath as she flicked the switch to turn off the power? How can
I do it without her, flick off the switch of life, decide on her fate or my own,
without consultation, alone? What if she goes and I’m inconsolable? 
What if she stays and doesn’t know me? 

And why am I seeing Durdle Door, that day when the Sea Scouts came upon us;
we were naked, swimming alone, so we thought. Why am I feeling the sting
of the storm on Mt. Aspiring as she yanked me

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Mom Journeys to the Other Side

William Bryan August 26, 2011 No Comments

William Bryan

Mom was not fully conscious when she crossed over, but I’m quite certain she was aware of both sides of the veil as she departed the realm of the living. This is a brief story of her dying. 

After my dad died, more than twenty years ago, my mom moved from our family home to live with my brother, Jim, and his wife, Barb. 

In retrospect, it was an act of supreme foresight, ensuring that she’d be able to stay in a family setting even if she became unable to care for herself at some point. She enjoyed many quality years with her four grandchildren and traveled with her family to Greece, Maui and Croatia, among other exotic places. 

Mom’s travels came to

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Finding Innisfree

Lawrence Dyche June 27, 2008 No Comments

Roger looked up at me over the oxygen mask, his eyes drawn wide by the sores stretching his face. He lifted a hand for me to take.

“I’m glad you’re here,” Jen had said before I’d entered his room. “They’ve taken him off a lot of the medication. He’s very lucid, but he’s depressed and scared.”

The previous fall, Roger and Jen had begun couples therapy with me. They were both thirty-two and had been together for ten years. Three years before they came to me, Roger had been diagnosed with leukemia. A bone-marrow transplant had left him cancer-free, but his prognosis was guarded. He and Jen argued frequently, his desire for independence clashing with her insistence on managing his care.

When they first visited

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Mothers and Meaning

John G. Scott May 23, 2008 1 Comment

“Dr. Scott, this is Dr. Font.” The call came from my mother’s cardiologist as I was about to see my first patient of the morning. “Your mother is worse. You’d better come as soon as you can. I don’t think she’ll survive the day.” Those blunt words shattered my denial: I had convinced myself that it was possible to fix the cumulative, lifelong damage wreaked on my mother’s heart by her atrial septal defect, a congenital condition.

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