Topicul asta e foarte mișto. Din el am scos faza asta, care e în linie cu ce am mai zis pe aici de câteva ori: după 70, corpul începe să doară și viața devine un chin, mai ales pentru cei care au neglijat sănătatea sau au avut joburi foarte solicitante, care au uzat corpul mai mult decât gușterii care au stat la birou și au scris pe bloguri.
Everything leading up to dying in the ICU.
Families of 85+ year olds with multiple comorbidities force us to keep "doing everything" to keep people alive far beyond any chance of recovering with any quality of life or dignity. Ever done CPR on a frail old body that weighs 95 lbs? The feeling of the cartilage and ribs crushing under your hands is something we never forget. After a few rounds of compressions, you can see a very obvious cavity in the chest that we have smashed into oblivion. And all for what? So the person can die in misery? Often, these people have written Do Not Resuscitarte and Do Not Intubate requests, but the family can override these once the patient is unable to participate in the conversation.
Then we get people 85+ years old with catastrophic strokes. Family decides to "do everything," so the patient ends up with a trach (hole in the neck) on a ventilator (breathing machine), a PEG tube in the stomach for liquid tube feeding, and resigned to bedrest for the remaining miserable months of their life. They will probably ultimately die of a steady but slow weight loss, horrible infected wounds from prolonged immobility (I have seen bed sores down to the bone and large enough to fit my fist in to), or infection (like pneumonia). All for what?
Then you get the younger ones, but the ones who are far past any sense of recovery. Some of the worst to watch are people with liver failure from alcohol abuse. They go through severe and difficult to manage alcohol withdrawal, in which they are confused, combative, and hallucinating. They are often sedated to the best of our ability and restrained for their own safety. Then come the bleeding problems associated with liver failure. I’ve seen someone go from talking to me and laughing to dying by vomiting all of the blood from their body due to esophageal varices (bleeding arteries in the throat/stomach). It looked like a murder scene, and the the patient was awake and aware she was dying as she bled out in front of us.
So if you talk to anybody who works in critical care, they will often have many examples of things worse than death. We essentially torture people every day. We see that slow, inevitable spiral down. We try our best to be realistic with patients and families, but it often doesn’t work.