Losing one’s parent or spouse is hard enough. Losing ones loved one and then forever questioning if you could have saved them is a type of living hell. As a doctor, I preached preventative medicine. Everyone agrees, it is better to prevent illness than to treat it.
Mr. “P’ is the perfect example of a spouse suffering intense emotional pain that could been prevented. The following is a real conversation that was all too common in my practice.
Mr. “P” – “Doc, did I kill my wife? I think I killed her. I can’t sleep. I cry all the time.”
Doc –” P” you know you didn’t kill her. The cancer took her from us. She fought hard and, in the end, went peacefully.”
“P”- “I can’t help but wonder if I should have kept her on the ventilator another week or two. She might have gotten better. I shouldn’t have turned it off.”
At this point, the conversation goes one of two ways. The first way is if his wife had advanced directives and she had discussed her wishes with him. The second, and more common way is when the two of them never had discussed her wishes.
Response to option one:
Doc- “”P”, you didn’t turn the respirator off. Despite your wanting to keep her alive, you did the hardest thing you could do. You honored her wishes! She made her wishes perfectly clear. She did not want to be on a ventilator. You did not kill your wife! You honored her wishes!”
Responding to option number two is not as easy. No matter what I say, Mr. “P” questions whether he should have kept her alive and hoped for a miracle for the rest of his life.
With thousands of people dying from Covid-19, it’s time to make your wishes known to your family and your doc! Tomorrow, I’ll address a similar but more complex problem.
When my husband was sick and in hospice at home we had a signed DNR taped to the mirror in the bedroom. I knew what he wanted. It is so important to have advanced directives in place so you can make it easier (?) for your loved ones if that decision becomes necessary. But having the decision made ahead of time doesn’t make the aftermath easier. But it may make getting to a better place come more quickly.
If you know that stopping resuscitation is not your order, but instead, your loved one’s order made while he/she could still make a decision, then dealing with the aftermath is easier.