Now it's a whole different story. I thought that after five years on an ambulance, I'd learned and grown as much as one possibly could in terms of dealing with death. But I was totally wrong.
The difference is now I'm dealing with people who are in the process of dying. This is completely different than death, and honestly I think it's a hundred times worse. Many of the patients are terminally ill, and come into the hospital thinking that they're just experiencing a bump in the road, that death is still always a comfortable distance away. But it's pretty obvious to us that it's not. It's almost frustrating that families see them admitted to the hospital and expect that since they weren't sent home with hospice that we'll just give them some medicine and send them on their way, back to living in that limbo of terminal illness indefinitely.
I know it's easy for me to be critical because I haven't had to experience it personally, but I hope that if I do at some point, I will be able to remember at least a little of my current perspective. Because honestly, what's best for the family isn't always best for the patient.
Healthcare professionals do a horrible job with end-of-life care, always asking, "Do you want us to do everything?" This question has one answer: of course. (Ok, unless you're about to inherit a bunch of money!) Then we stick tubes and needles in the patient, hook them to machines that beep and pump and rumble, and ironically the decision becomes infinitely more difficult. We can keep people "living" like this for years (remember Terry Schiavo?), and every day you have to ask yourself, do we stop the patient's suffering or do we hold out for that impossible miracle?
One of the doctors reflected on it, remarking that we are treating people like science experiments, pumping things in them and seeing what comes out, because we don't really know how to make them better at this stage of their illness.
Doctors are getting better about giving options now- giving antibiotics, medicines that may help, but suggesting that certain futile measures be withheld.
Yesterday a patient came in, talking and alert, but not feeling well. He knew his disease was terminal, but he thought he had a while to live, but we found out yesterday that his cancer had returned and was overwhelming his body. When asked during a procedure how he was doing, he turned and looked at me and said, "It's not every day that someone tells you that you are dying."
I had no idea what I'd say to that. The doctor stopped what he was doing and responded, "Maybe this is a good thing. I could walk outside today and get hit by a car, and I wouldn't have had time to get my affairs in order or say goodbye to my family." I know it was hard to hear for the patient, but the doctor is right. Now this man can make sure that his death is dignified, that ridiculous measures aren't carried out, that his suffering isn't prolonged.
Another patient of mine unexpectedly became seriously ill, and now his wife is having to make all these gut-wrenching decisions about what she thinks he would have wanted, all while trying to accept the fact that she's about to lose the love of her life.
Listening to the doctors talk among themselves, you begin to see that the easiest families to deal with are the ones who are able to put their own feelings aside for the good of the patient. It may be a tiny bit easier when they've been suffering for a long time, but it's never an easy decision to turn off life support or agree to a do-not-resuscitate order. No one wants to be responsible for letting someone die, when they aren't 100% sure that that person couldn't have been saved. But in this time of advanced technology, people rarely just die anymore.
Advances in medicine are mind-blowing, saving lives and improving quality of life. But they also change the definition of death and dying, and now more than ever, loved ones are having to take responsibility for end-of-life decisions.
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