What do you want us to do if your heart stops beating?
What are your end of life wishes? Have you even thought about it? Do your loved ones know what you want? What if something happened today, are your ready for the consequences of not making your wishes known? Are you ready for the impact it will have on those who survive you?
Do you really know what happens when you ask us to “do everything?”
Imagine a cold, sterile environment. Your heart has stopped and you are on a hard gurney surrounded by chaos. It is determined you have no pulse, and CPR is started. You manage to survive broken ribs, a breathing tube down your throat, line and shocks and wires and being stripped naked in front of strangers in a cold room. You’re then wheeled up to an ICU bed where you spend countless hours or days in a medically-induced coma. If you awaken, you’re unable to breathe on your own, unable to speak, often unable to move.
You think, “This is not what I wanted.” But it’s too late.
Will I survive?
Weeks later, if you are one of the 24% who even survive a code, you make it out of the ICU (this number assumes you don’t already have a chronic illness or other life-limiting condition). You have PTSD and/or post-ICU psychosis. Did you know that 1/3 of patients discharged from the ICU have cognitive impairment similar to a traumatic brain injury or Alzheimer’s Disease? Others face possible PTSD and depression. You have healing rib fractures. You may be dependent on multiple medications. Are you on dialysis too? Would it still have been worth it?
How can I prevent this if this is something I don’t want?
This scenario is entirely preventable by YOU. Tell someone you care about what your values and wishes are. Here’s a great way to break the ice. It doesn’t matter how old you are. Have the conversation NOW.
Maybe you are young and you want everything up until the doctors say they have tried everything. Maybe you are older, have a terminal diagnosis, etc: do you really want to die like this? 20% die in this cold, sterile, painful setting, forced by protocol into torture followed by inevitable death. It always seems too soon until it’s too late…talk about it now.
Who can I ask to carry out my wishes?
Pick someone who will be able to carry out your wishes under stress without letting their emotions interfere with carrying our your wishes. Use resources to guide you in finding the right person, talking about your wishes to someone who may not agree with you, and talking with your healthcare team.
ZPac [those who follow ZDogg on social media], talk with your loved ones today. Watch the original video on Facebook and share this with your friends, family, neighbors, and coworkers. No one is too young to talk about this today. Leave your comments, I’d love to hear your thoughts and experiences because they can inform and guide others!
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Reprinted by permission of the author, with some reformatting by the editor.
Dr. Zubin Damania (ZDoggMD) is Founder of Turntable Health, a direct primary care clinic in downtown Las Vegas. He is a UCSF/Stanford trained internal medicine physician. During a decade-long career as a hospitalist at Stanford, he performed stand-up comedy for medical audiences worldwide as a way to address his own professional burnout. He produces videos and live shows to educate patients and providers while mercilessly satirizing what he views as a dysfunctional healthcare system. More about him can be found at his website.
It depends. I’d never rule it out categorically. If it happened today, as a healthy person, retired, able to everything that I want to do. Sure, I’d say, why not? What do I have to lose? If I were in my 90s, frail, and terminally ill, the answer would most likely be no. In between, probably yes, but maybe not. It would depend on the circumstances. In no case, would I want a young ER resident or attending think that I (or anyone else) is not worth saving based on age, physical disability, or cognitive disability. That’s not her or his decision to make. Quality of life is subjective. If someone comes by ambulance from an assisted-living center or nursing home, no one should ever assume that person would rather die than return if if he/she comes back more disabled than he/she did entering the hospital.