The Line
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Why would a n y o n e want to live this way ?” he said to me in the trauma room in the emergency department with his wife in the bed next to him . I simply replied , “ I don ’ t think many people would .” A few moments later I added , “ Without a DNR discussion and signature , unfortunately , you will now have to decide if she lives this way or not .”
He had witnessed his wife getting chest compressions for 20 minutes . They were able to return her cardiac function but , sadly , without any other signs of life . She had been failing in health over the years . While the family watched her decline , the married couple of 59 years didn ’ t want to talk about their lives in that way . Now , the husband wished they had , as the decision of what to do was falling on him .
She was moved to the ICU where the ventilator kept her alive . The family circled around her and waited to hear about her brain function and what could be done . The neurologist was incredible in
by KRIS BARNSFATHER , MD
the way he communicated possibilities and outcomes and potential imaging if they wanted it . He did an excellent job walking the line between compassion and clinical , between factual and faithful .
“ What organs are still working ?” the husband asked me . I replied , “ Her heart is getting medicine to make it pump and her lungs are getting help breathing . Without them , she would pass .” An hour later her heart stopped needing pressors and she was only requiring ventilation . It was a mixed signal to the family . They looked to me for answers on her brain function and potential for improvement .
I had work left to do in the hospital , so I turned to the family and told them I would be back soon . One of the sons nodded to me and I turned and left . There was a limit to people in the ICU room , but the amazing nurse knew the score and let the entire family stay . They were quiet , respectful and loving .
I returned to the room later to find the situation unchanged . New family members had arrived , and others had gone home to feed animals and take showers . Each test result that came back showed no change in potential for her recovery , but the family stayed hopeful she would regain brain function soon . I knew she wouldn ’ t . I knew the lack of oxygen to her brain would be too much for her to have any kind of recovery . I , too , walked the line . Only my line was be-
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