Loc: Indiana, USA
The next day, the doctor explained the plan for Mom:
- She would be kept chemically comatose while swelling reduced and some healing began.
- After several days of this, they would attempt to awaken her. (There was a real possibility that she would never waken.)
- If she woke, she'd likely be unable to communicate because she was dependent on the ventilator, it was hoped temporarily.
- Each morning, a respiratory technician would put the ventilator into a "passive" mode (pressure-support-mode, kind of like a CPAP) and see if her body attempted to initiate breaths. If not, they would try again the next morning. [It was implied, but unstated that eventually one gives up on this.]
- Once her body was initiating breathing on its own, she could be de-intubated and we could then assess how much of "her" was still there.
I stayed in the hospital for a few days, but then the story took a bit of a turn. My father was generally a kind person, though we had always had a somewhat tense relationship. Sadly, he could not acknowledge the limitations that age and his own brain injury had imposed on him. Exhaustion, stress, and (for him) growing confusing led to a quarrel. In his pique, he demanded that the police remove me from the hospital. I returned to my own family and work and relied on my out-of-state sisters to relay information from the nurses as they were prohibited from speaking to me.
One afternoon, I get a call from my hysterical sister telling me that Mom was going to die—today! While she tried to explain, my other sister called and it became a conference call.
"But you told me things were looking good…that the respiratory tech said her self-initiated breaths were getting stronger…?" I said.
They said they were also shocked, but that Dad had called and informed them that it was hopeless and that they were withdrawing all care, including intravenous feeding. My sisters begged me to go and plead with him to postpone while they made quick travel arrangements. I raced to the hospital and thought it not terribly likely I'd be arrested for ignoring the order I stay away. I spoke to a nurse on the ward who told me that they were withdrawing all care "at the request of the next of kin". I asked what had changed in her condition.
"I think he just gave up. He said, 'It was time,'" she replied.
I then recognized the respiratory technician whom I'd met before my expulsion. I asked him what he knew. He expressed shock when I said they were withdrawing care. "That's surprising! I just told your father this morning that it was time to take her off the 'vent'."
It was then I realized that my dad, hearing "It's time to take her off the 'vent'," misunderstood that to mean, it's time to pull the plug. He proceeded to say his farewells after the technician withdrew, then went to the nurses' station and requested they "unplug everything". Now, no sane person could talk to Dad for more than 5 minutes about something more complex than the day's weather without realizing he had difficulty understanding and expressing complicated ideas, but they dutifully charged down the path of (passively) killing their patient without even the slightest question.
I latched onto the respiratory tech, grabbed a nurse, who summoned a doctor. We all joined Dad in Mom's room and I put my theory of the misunderstanding to the test and Dad confirmed my speculation. He had thought the respiratory tech meant it was "time to let her go", not "it's time to let her breathe on her own". Eventually a couple more nurses and another doctor arrived and *they refused to reverse their plan*. Why? Because, she was a DNR (do not resuscitate) patient! [My argument that that status was assigned based on a misunderstanding caused them to debate among themselves and I felt like Annie Wilkes ranting in *Misery*—"Have you all got amnesia? This isn't fair!"] While they discussed, I went down the hall, found an unfamiliar nurse and asked her to page the neurosurgeon to Mom's room.
The surgeon, when he arrived, was like a superhero. He charged in, seized Mom's chart from two arguing doctors without so much as an "Excuse me" and asked what was going on. As they started to explain that the plan was to withdraw all care, he announced, "No, we're not doing that." He proceeded to de-intubate Mom who, freed of that tube, was able to speak to us right away. She was confused and suffered memory problems for the rest of her life, somewhat like "Dory" from *Finding Nemo*, but not as severe, but she knew who Dad and I were and within a few minutes was laughing with me about the time I had (aged 4 or 5?) broken her glasses while Dad was at work. She asked about my sisters and I explained they were on their way.
She had a long recovery, but she (and we) enjoyed several more years together that her children and grandchildren are grateful to have had.
One last thing, though. That evening, I discreetly asked the nurse to remove the "DNR" bracelet from her arm, not wanting to trumpet to Mom that someone had made that decision while she was unconscious. (I don't blame Dad; I was just hoping to avoid any bad feelings for anyone because of that.) Amazingly, they REFUSED! I explained that she had not chosen that status (not to mention that it violated the terms of the aforementioned living will, which stipulated separate opinions from independent doctors that she was "unlikely to ever regain consciousness"). They told me that it was simply not possible to remove DNR status. I worried that she could have some other medical problem while still hospitalized and be denied care because of the bracelet. [I later confirmed that she would have been.]
After I threatened suit the next day, a board of hospital doctors convened a meeting in a conference room, including my dad, brother-in-law, and self, but *not* my mother (!!) and agreed to revoke the DNR status.
Anyway, that experience is one that I think is illustrative of the bias towards death in today's medical community.
I apologize for the long, rambling narrative. I guess I should have brushed up in "On Writing Well" before starting this.