On Dying | cedricsmom's Blog
I wrote an order to discontinue life support this morning. It was the first time I ever had to do that. I stood next this womans bed as a machine pushed air into her lungs. Her niece was the only family member present. She was angry that her aunt had been intubated because she had asked never to be placed on life support.
To be fair to the doctors, there was no paperwork available to confirm this and no family members were present when it was decided that she should be placed on a ventilator. The paperwork was located about the time that the niece showed up. She was angry and frustrated because she felt like her aunts free will had been violated.
After discussion with this patients niece, review of the paperwork, and a meeting between all involved, it was explained that stopping the ventilator would likely result in the death of Dorothy. Her niece said that she understood, but she wanted to be respectful. Then she started asking questions. If they left her on life support, would she pull through? If her lungs had failed once, wasn't it likely she would die soon anyway? Was she doing the right thing?
Assuring someone that they are doing the right thing is hard. Because how do you know what the right thing is? We are not endowed with the gift to see the future. We don't know what will happen or how our decisions will turn out. We have no right to play God, and we have no right to assume that we know best. Yet we do. Everyday.
I have struggled with this over the ten years I've been practicing medicine. Finally I found peace in realizing that no matter what decsions we make God is in charge. The Bible says our days our numbered before we are born. I've seen examples of this time and again. A man with every hope of survival after a 30 foot fall, stable and comfortable, and even a little excited about his first helicoptor ride to a larger hospital for surgery. Plenty of time. But the elevator wouldn't work, and the helicoptor couldn't take off once they finally got him loaded in. He died on the roof of the hospital due to all the technical failures surrounding his transfer. It was his time. A young woman, 19 years old, in a car accident that should have been fatal. She sustained so much trauma she was in the hospital for a month before they upgraded her condition to stable. I saw her at kroger last week. It was not her time.
And Dorothy. She was extubated this morning and expected to pass quickly. When I left the hospital at 3:30 this afternoon, she was awake, alert, and comfortably beginning her recovery. It is not her time.
Many doctors operate on the principal that they hold life and death in the palm of their hands. I disagree. I believe we will die on the day pre-determined before we were born. No miracle of technology or gifted physician can change that.
I think that's why it's important to live each day as though it counts. Because it does. And there are no second chances.
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A better friend, posted April 29th, 2013
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