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That would be temporary, but she would likely be heavily sedated while hooked up to the machine. My friend was also surprised to learn that his mom would have to be chemically paralyzed to avoid gagging when the tube would be placed down her throat. But it does nothing to reverse a progressive neurological disease. That help seems a good thing, which it often is.
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I started by explaining intubation, in which a machine would breathe for his mother.
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Like so many people in his position, he struggled with how "aggressive" to be.Ĭould he presume that his mother would want him to prohibit doctors from putting her on a machine that would breathe for her? From resuscitating her? What does resuscitation even mean? And how should he ask her these questions in her rare moments of lucid thinking? He showed me a sampling of the forms, highlighting his points of confusion. These experiences piqued an interest in end-of-life issues, and I had seen many families face these kinds of questions. As a fourth-year medical student, I had completed my clinical rotations. My friend is an accomplished researcher, but he struggled to find reliable information to plan for his mother's decline.
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He was ladened with a thick envelope from her lawyer's office, full of forms with boxes he was supposed to check off to select the details of how his mother's last days might unfold. He described the vibrant woman who raised him, and the woman she had become, unable to walk, feed herself, or, toughest of all, think clearly. But there was nothing in his infinite stores of energy and talent that could help his mother. My friend is a high-achieving lawyer, Mandarin speaker, and entrepreneur with multiple Ivy League degrees. As he described coming home to be with her, his spine slumped, his speech slowed, and for a moment his eyes looked full, as if he might cry. He mentioned that he was in town because his mom was sick - quite sick - with an uncommon and incurable neurological disorder. We talked about his career changes and my progress through medical school. I had no idea that on this break from the hospital, I would end up having my most gratifying medical discussion yet. It is a life-threatening condition that can ultimately require open heart surgery to take out the infected valve and replace it with an artificial one.Ĭhristopher’s turn: Planning a death with dignityĭressed in jeans and a sweater - white coat hanging off-duty at home - I met up with an old friend on a sunny afternoon in Philadelphia last summer. Bacteria introduced to the bloodstream via intravenous drugs can ravage the heart valves – a condition called endocarditis. Second, whatever he'd been told at the hospital about caring for this serious wound was lost entirely in the translation to his daily reality.Īs a cardiac surgery resident, I often meet patients who are in drug addiction. First, he wanted to get better – the fact he was off heroin made that much clear - but he didn't know how. As I worked and we talked, I realized two things. "Stay here for a moment, I'll be right back." I dashed over to a nearby CVS for supplies, and came back to clean and wrap his hand. Do you think I need to go back? I feel fine." He continued to pick at the wound with his dirty right hand. "They did give me a prescription for antibiotics and told me I needed to take it, but I can't seem to find it.
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Were you prescribed antibiotics? What happened to your bandages?" "I'm afraid your infection is coming back.