……like that.
She was sent to the ER because her doctor heard something odd in her lungs. She walked in on her daughter’s arm. The 95 year old woman was laughing and joking with the staff when she arrived, but offered no specific complaint.
The doctor thought he heard a pneumonia, and he wanted it treated with IV antibiotics. The ER doc felt she was not acutely ill, and could be treated as an outpatient, but asked me to evaluate her anyway.
When I arrived in ER a few minutes later, she was clammy, breathing rapidly and acutely short of breath. Her lungs sounded full of fluid and coarse.
I felt she had flash pulmonary edema, a sudden flood of fluid into the lungs. She had an underlying heart problem that would make that very possible, and only treatable by open heart surgery
I asked her daughter about code status…did she want to be hooked up to a ventilator to breathe? Or to have chest compressions to restart her heart should it stop?
No, and No! The patient had made it clear to her family that she wanted no heroics, no intervention.
I walked out of the room to write some orders, and within minutes the nurse informed me that the patient had stopped breathing and her heart had stopped.
All within 30 minutes.
I am a physician. It is my job to “save lives.” It is also my job to listen to my patient’s wishes regarding treatment….or not.
I can only hope that when my time comes, it will be as rapid and “undramatic” as hers.
Rest in peace, Mrs. Y.
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