Sunday, April 27, 2008

One more piece of information

One day I paused to listen to a doctor as he spoke with the family of a dying patient. Looking at the monitor I could see the telltale wide QRS waves of a dying heart. The patient would be dead within an hour or two. The doctor explained that there was nothing more that could be done and that we were keeping the patient as comfortable as possible. After the doctor left the patient’s nurse invited the family back into the patient’s room. The patient was on isolation precautions and this would entail putting on isolation gowns again. The family declined. The nurse registered slight disapproval that the family did not want to be with the patient in her last moments and then moved on. After she left I approached the family and asked them if they understood what the doctor had told them. They said they thought they did. I said, “So you realize it is happening right now and she only has an hour or two at the most?” The husband drew a quick breath. They had not realized. They became activated and decided what to do. The rest of the relatives, including the patient’s young daughter, were brought to the room to say goodbyes. After a few minutes some of the visitors left, taking with them the young daughter, who did not understand what was happening and kept telling them that everything was going to be okay. I returned to my own patients. That patient died shortly thereafter.

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