Most people probably look at the above question and wonder if I am sitting in the dark listening to The Cure. I assure you that is not the case. This blog is not meant to be a depressive, dark, bleak look at the end of our lives. This blog is not even about the finality of death. Besides, one could argue that death is only the beginning. But the beginning of what exactly? As a Christian I believe, if I get my act together, that eternal life with my creator awaits. Buddhists believe in reincarnation on a journey to Nirvana. Muslims believe in a "resting period" for the soul until judgment day. Whatever our beliefs on the afterlife, we are playing a big game of wait and see. But we can have some control of the end of our time here on this planet, spiritual plane, or whatever you want to call it.
How many of us have actually thought about our last days and what condition we will be in? I have. I make sure my Mom has. I make sure my students do. Why do I do this? Why do I point out something that most people like to keep buried in the basement of reason and emotion? Because I watch people die badly. I see people put through possible pain and physical torture because many people are too scared to sit down and be honest with themselves and their loved ones. I hope this short opinion serves as a clarion call to those of you in denial about our only true fate.
This past Saturday I participated in yet another desecration of the human body. Justin and I were called out to my favorite address (HIPPA prevents the listing) for a 74 year old male in cardiac arrest. The "patient" had a history of heart, kidney, and other various conditions. I do not know the specific reasons for his being placed into the "skilled nursing facility", but I have seen enough of these to know that it was probably for one of the following reasons:
1. Family did not have the time/resources to care for him.
2. Family did not have the want to "deal" with him.
3. Family was basically "warehousing" him until he was dead.
Regardless of the reason, this patient was now on his way to find out the truth about the afterlife. Unfortunately, he did not get to do so easily.
Our patient's body, I sincerely hope he was unable to feel anything, received abuse and punishment that would probably kill him if he was not dead already. He was being "worked" when we arrived. CPR is not gentle. Sure, when you are getting certified and you are doing chest compressions everything feels nice and pliable. Everything pops back in place. Real life CPR compressions are different, especially in the elderly. I counted seven "pops" as I did compressions. The "pops" were ribs I was breaking as I tried to get blood moving to his heart and brain. We inserted, jammed is probably a better word, a large plastic tube down his throat. We stuck him with needles and shot enough epi into him to get a pulse out of a stone. We even got to watch the ER staff suction about 250 cc's of blood out of his airway because of the trauma that had been done to his lungs during whole affair. After abusing this guy's corpse for about 30 minutes it was finally over. The ER doc told everyone to stop and the body could finally rest.
When you quit breathing and your heart stops beating that is usually the end. Some get to come back; you hear stories about it all of the time. I can even say that I have truly brought someone back from the dead. Most of the time however, that is the end of the line; unless EMS gets involved. See when we get called we HAVE to act. Once you tell us that you don't know how long mom has been down or that "I was just talking to him" we have to start "life saving" procedures. There are only a couple of ways around this. You are either very obviously dead, or you have the proper paperwork in place.
This person was a "full code". That term refers to the fact that all possible interventions are to be used to prolong life. That means that no matter how futile the attempt will be you want everything done. That includes life support should you be "lucky" enough to regain a pulse. You get to exist because you are hooked up to a machine that breathes for you and you get fed by an IV line. You are stuck in a state of purgatory on earth until your heart finally quits. Was this how you wanted your life to end? For those of you thinking about your families, is this how you would want their life to end?
This is a very emotional topic, but I think it is a very crucial one. I encourage all of you to discuss your wants with your family. This decision may never have to be made. I plan to go out in the middle of a threesome with Fergie and Giada from a massive stroke myself. I can promise you that I have had these discussions with my family and friends. I will encourage all of those I love to make these decisions for themselves before a scared/selfish family member makes it for you. Matt you know where the 9mm is if Emilee balks right?
Stay Safe,
Rob
If I catch you in a threesome (even if they are on your list) you won't have to worry about the stroke... and I know where the gun is :)
ReplyDeleteYou tell him Em!
ReplyDeleteThreesome indeed. Probably having trouble keeping up with one. :o)
Good subject - some wrinkles - but still a good subject.
Our wishes are well known also (WE have no doubts about where we are headed - and it definitely looking better all the time), but it brings up an interesting question. Where is the all important paper work kept?
Do the EMT's look in your butt-crack? Search the house/car before doing anything? What if the other members of the threesome are too stunned to make sense? Suppose they are out cold too?
There really does need to be a "better way". If for nothing else, to stop you guys from screwing-up a perfectly good corpse.
Opportunity knocks? They laughed at the MedAlert thingies too.
'Noid
Emilee, that was HYSTERICAL! These blogs are great, but I vote Emilee comments on them all from now on.
ReplyDeleteGreat subject. Even if your wishes are discussed and agreed upon w/ your family, are they strong enough to follow through. I have been on several codes w/ valid, signed, on orange paper w/ photograph DNR (Do Not Resuscitate) order only to have to work the poor patient because the family and/or medical Power of Attorney wants you to. I can imagine that it is hard to let a close family member go (I have luckily not had to go through it yet), but why would anyone want to put a loved one through that simply because they are not strong enough to deal w/ the death and the mourning process. To me it is delaying the inevitable and disrespecting the wishes of a loved one when it should be respected the most.
ReplyDeleteGood subject, Rob!
ReplyDeleteBill works in the healthcare profession, and he often sees the results of 'when someone is brought back'--another question: would you want to be brought back if you knew what you would be after 'all possible interventions' were taken to save your life?
Bill went out to a rehab facility not long ago for a patient--to fit her with braces where her muscles are atrophying-- and two of her doctors--a pulmonologist and a neurologist--was there.
The patient was a seventeen year old girl....the girl that we all probably wanted to be in high school. Cheerleader. Popular. Pretty.....from Bill's description, this girl never knew what it was like to spend a Friday night at home alone.
Her mother came home to find her hanging from her ceiling. From what Bill has read on her medical charts and spoken of with her doctors--she was as dead as the proverbial doornail when the paramedics cut her down. Epi worked, however....they got a pulse and took her to the hospital.
All the docs could do was stabilize her and send her to a rehab facility. Bill said that the neurologist told him she has no brain waves. She's brain dead...her condition is permanent. I understand the agony her parents must feel, but I almost think it would be harder to see her in the shape Bill says she's in--because it's very, very ugly.
My Uncle Allan was a firefighter/paramedic with the Kettering, Ohio Fire Department for over thirty years. He has expressed much what you have expressed in your post today. He said he almost felt physically sick, and even angry sometimes--and these are his words, not mine--when you show up to a call and the patient is laying in the floor puking and shitting everywhere, and he knew they weren't going to make it. But the family is there, they're yelling, they're crying--they're begging you to do something. And he said it was so hard sometimes NOT to tell the family that what they were about to see--what they were about to see was the squad trying to save their loved one's life--would be worse than watching what they were just seeing: the natural death process.
My mother's last days were terrible. Her last night on this Earth was pure Hell. I am also a Christian.....but I have to say, that night I was ready to part with my faith's position on euthanasia. To this day, I'm not entirely sure of my position on it.
Bill has said give him 24 hours. If it doesn't look good after that......pull the plug; and this is if, God forbid, he has been in an accident or soemthing of that nature. If he had been suffering from an illness, I am sure his wishes would be to let him go. I feel much the same--you can't argue with an EEG that has no brain waves; and if you're only going to bring me back to having something like Stage IV cancer or something equally horrible.......?
DNR.
Lynn
"I've always said my final tattoo will be "DNR" across my chest. My dear, dear Granny Dot died two years ago last week, and spent her last couple of days in hospice, like a lot of folks do. Luckily, she had been smart before the Alzheimer's got too bad, and had a living will stating that she did not want to be intubated, or have a feeding tube, or even IVs. She got to die in her bed with most of her family around her. But when my sister found out that she wasn't being fed or hydrated, she went BESERK. She started crying and screaming that we should just go ahead and call Dr. Kovorkian to come and kill her. It made it a lot harder to deal with to have to try and justify the cruelty behind having end-stage Alzheimer's and trying to prolong death with tubes and drugs.
ReplyDeleteBut perhaps we are jaded about death because of our jobs. We see how ugly it is to try to prevent it, and we see the true quality of life that most people live. But unless there is a 99% chance you can bring me back to my full and intact mental status, don't work me. Or I will come back and haunt your ass unmercilessly. :-)" Leanne
Moderator copied over from facebook.
Hey Noid, how did you find out I'm having trouble with just one? There are a few places to look. If you have a vial of life sticker on your door that lets me know to look in the fridge. If you wear a bracelet or necklace I should find it. Tattooed to your chest is a subtle reminder. I do not ever recall going crack hunting to find one though.
ReplyDeleteThere was a guy in AZ. A retired general practice MD. that had the legal orange DNR sheet, complete with signatures tattooed to his chest. He had inoperable brain cancer. Seeing it when he first got it was funny. After the 4th time I transported him for "stroke like symptoms", it started to make sense. He died 3 weeks after he got the tattoo. Luckily at home, with his family letting him go with class, integrity and the knowledge that he lived a full life and it was time to go
ReplyDeleteohh, and I was told he died with a cigar in one hand and a single malt in the other. I think Rob will agree there would be worse ways.
ReplyDeleteDepends on the Single Malt!
ReplyDeleteThe worst single malt is still better than the best blend. Also known to have strange medicinal powers - makes people think they can talk without spitting, that the cute waitress really does think you are hot, causes some folks to tell everyone how much they love them (again), etc. Some people even eat vast amounts of really hot peppers - then go sh*t in the creek to keep from setting the woods on fire. Wonderful stuff.
ReplyDeleteSo you are saying they already have a thingy that says DNR. Damn. Another marketing idea shot down.
My point was, you can't be carrying this crap around with you 24-7 unless there is a universal, legal and SMALL way to do it.
If the relatives are getting in the way, shut them up. What do you think those paddles are for?
As for the "can't handle one" - do you forget where I work. We see you and hear you EVERYWHERE, just like the left says. BTW - stop being so nasty to your mom and sister on the phone. (Work humor)
'Noid
I just read this again, Rob.
ReplyDeleteAnd it made me think about the first time I got certified--we have to before we are accepted into the nursing program.
I was thinking about those resilient little dummeies we were giving compressions. And--how ginger we all were being with them. Our instructor--an ER nurse of 25 years, snatched one away from us and showed us just HOW to do compressions.
I actually experienced pity for an inanimate object that day.
And her words stiil ring: "Life before limb, people. You have to put your weight behind it. You're going to break ribs--get THAT through your head now. If you can't stand that idea--go be a cosmetician."
I admit--not much about the prospect of what I will see as a nurse bothers me. The only thing that ever really bothered me was watching someone have a seizure--something I find truly frightening. (I got over that because someone had one at work.....the general consensus was that it was his diabetes. The seizure itself didn't last long--and one of the other guys told me he'd had another such episode just two days before; and when I sent someone after his blood sugar test kit, his blood sugar was 103.)
Now--I've got EMT I certification, and I'm only a third year nursing student--but diabetes was the farthest thing from my line of thinking. I was very inclined toward head injury--I was looking at him very carefully, and his pupils were uneven. Both were responsive--but uneven.
As it turns out, Jim had a benign tumor in the occipital lobe of his brain.
When I got called back there that day--I was PRAYING I wasn't about to have to do CPR. (Only to find him having a seizure.) It's now the ONE thing that scares the shit out of me: I'm going to have to break someone's rib. I just hope I don't freak out when I do it.
Lynn
Oooops, my bad. This would have been the second time I got certified--the time I did it when I got EMT I, the guy who was my instructor then wasn't nearly as enthusiastic....:/
ReplyDelete