Thursday, March 08, 2007

Not with a bang

We code them sometimes. Mostly, they have DNR orders, but sometimes they die too soon after being admitted, or there's a family member who simply won't accept the fact that, after Mama had blood filling the ventriculostomy burette, there's little likelihood she'll sit up and ask for a Coke. So we come in, all efficiency and organization: the RN from the ICU who's on the code team, the youngest residents to do compression, the chief to run the code, and somebody like me to do odds-and-ends stuff like record with one hand while starting IVs with the other.

That is not a way to die. You wouldn't know it from heroic stories in the news and touching scenes on That Popular Medical Drama, but we only get about a third of them back. Maybe forty percent, on a good day with the wind setting right.

It's not a good way to die, with two kids trading chances to compress your sternum and crack your ribs. It's not a good way to die, with a preternaturally calm voice calling out "one amp epi, eighteen-forty-two". And it's especially not a good way to die, with air blown into your lungs from a big bag escaping through lax vocal cords with a quiet "gk gk gk" as those aforementioned kids whang on your chest.

Do not ever code me. If I didn't hate wearing bangs, I'd have "DNR" tattooed on my forehead.

Instead, I'd like to die like this: all my kids are around the bed, along with the oldest of their children. I've made it perfectly clear from the get-go, since the stroke, that I have zero desire to be fed through a tube and rehydrated with catheters in my veins.

So the kids come in and take shifts, talking to me when I'm awake, sitting and talking among themselves when I'm not. At some point in the proceedings, they'll all come in at once, since it's obvious I won't last much longer.

And the kids will go out into the hall to catch the nurses that have taken care of me, to give them a chance to say goodbye.

Maybe, if I'm very lucky, my heart will simply stop beating after the last nurse comes in and wishes me a safe journey.

I've hung out with the dead and with the dying. Never before has somebody simply gone out like a candle when I was right there. It happened so quietly we didn't even know it had, and when I realized she was dead, I was filled with immense gratitude and happiness for her.

That is the way to die. If I get my choice, I want it to be with people who love me cheering me on to the next world, not with strangers trying to make me miss my train.


Anonymous said...

Oh, yeah Baby. I'm printing that out and adding it to my advanced directive.

Devorah said...

That's how my mother-in-law went, with DNRs signed from the minute she hit the ER to all of us standing around her bed a week later. Thank you for sharing reality with us.

Anonymous said...

My sentiments exactly.

shrimplate said...

Quietly, with a morphine drip and Hildegard von Bingen playing softly in the background. Good coffee for the visitors.

When I die I don't anybody standing around complaining about crappy coffee.

Anonymous said...

My favorites are the patients with the diagonoses failure to die, or also know as failure to let me die. These have families that want everything done because comatose fixed pupils mama with the permanent "Q" sign, bloating up secondary to the gases produced from the decompostion from the inside out, twitched and that was interpreted by loving daughter as as hello darling daughter I love you, and I am just playing dead.

Cartoon Characters said...

"That is the way to die. If I get my choice, I want it to be with people who love me cheering me on to the next world, not with strangers trying to make me miss my train."

I am copying this and framing it and putting it up on on my wall.......... that quote is a classic.