Tuesday, January 07, 2014

On Fighting the Fight After the Fight is Gone

If I didn’t have such an issue with using my body as a canvas, I’d have a tattoo across my chest that reads “If the brain waves are gone, then let me go.”  It’s not the same as tattooing “Do Not Resuscitate”.  That suggests not even trying when there is the possibility that I could be brought back to quality existence, and I really would like someone to try once before quits is called and any of my organs which are useful are donated to help someone else continue. 

Back in the mid-1980s, my eldest sister suffered a massive internal bleed due to a ruptured spleen and she ended up in the ICU on full life support.  All the signs indicated irreversible shock, multiple organ failure and brain death.  As an EMT and also having worked in a hospital, I knew what all that meant.  My mother, who was a nurse, also knew what that meant.  We and the rest of the family were devastated, but we also knew that the only thing keeping her heart beating was the air that was being pushed in and being allowed to escape by the ventilator.  Yes, she might have continued indefinitely on the ventilator with IVs and/or a feeding tube in place.  But, we knew it’s not what she wanted.  The bleed happened on New Year’s Day and she died the following morning.

Despite my sister’s health and other issues, she was a sweetheart.  She was loving and caring and would give you the shirt off her back if you needed it.  She was a free spirit and would never let anyone tether her to tubes and machines just to keep her body going in the hope that maybe she might wake up later on. 

So-called miracles have happened when someone who was in a coma woke up months or years later, but those are exception rather than the rule.  The body has some incredible abilities to heal itself, given adequate time.  Even the brain has been known to circumvent serious injury.  Thing is, the damage can be so extensive that the body can’t deal with it all in even a normal length of lifetime, leaving the person unable to wake, dependent on others for every little thing, and unable to chose whether or not they really want that existence for the rest of their days.

For my sister, I believe she made the decision for everyone concerned when she went into cardiac arrest the next morning and didn’t respond to all the measures taken to bring her back again.  For my mother, she chose not to be on a ventilator in her final two days; she had been on one, sedated, for two weeks prior to her conscious decision.  I was her health care proxy and knew that her choice meant she was going to die, but that it’s what she wanted even in her last comatose hours.  She was a woman who preferred being able to do things for herself and that included breathing.

Every comatose person’s situation is unique.  Every family’s response is unique.  It’s hard to make the decision about whether to continue fighting or let a loved one go and anyone who hasn’t had to deal with the situation can’t really understand the anguish involved in making it.  But, I have and I do.  Like my parents, I want quality time while I’m here and if I can no longer have that, if I can no longer interact with the world in the way I have all my life, then pull the plug and the tubes and let me go.  Take what you want and fry the rest, meaning donate any viable organs and cremate my remains.  The paperwork for it all is in place and my remaining family members are aware of my choices and I’m confident they will honor them.

For anyone else facing this unpleasant situation, I ask only that you consider what your comatose family member would want, how they would want to spend part or the rest of their life and how they would want to you to be for that same amount of time.  Think of how they would answer if asked and decide from there.

“Is it true that God answers all prayers?”
”Yes – and sometimes, the answer is no.”
                                                            From the TV series M*A*S*H

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