Wednesday, September 5, 2012

What kind of death would you like to have?

Dear Listserve,

I am not asking my question rhetorically. I am a doctor, and I need to know.

A “code” is an emergency that sends a large team of doctors, nurses, technicians and others to a patient who is unresponsive, not breathing, or pulseless. It is a frenzy of activity. Unless a designated representative of the patient says otherwise, the team springs into action and determines whether to begin CPR. The process involves much more than pounding on a chest for a minute, and that by itself can be violent. Ribs are broken, and the patient rocks from side to side from the force required. Orders are yelled across the room. And if the patient does not begin breathing spontaneously soon, they may put a tube down his trachea and connect him to a machine that will breathe for him.

On television, the survival rate when something like this happens is close to 50%. In reality, a patient whose heart stops has about a 15% chance of surviving to leave the hospital. Survival does not guarantee quality of life. There may be brain damage or other problems. This being said, an attempt at resuscitation is appropriate for many people--and for many others, it is not.

Your current state of health, age, and other factors affect your chances for a good recovery. Depending on how things go, breathing machines, surgeries, loss of functional capacity, or rehabilitation may follow. Think about this decision and discuss it with your family before you are hospitalized. Ask your doctor if you need help. "Five Wishes" is a good place to start.


T.
Denver, Colorado

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