DNR
“So, it looks like we are in agreement, mmm?” it was more of a hopeful statement than a question. My wife was leaning back in her chair, looking over the view from our balcony. At long last she breathed in deeply and said, barely audibly, “I guess so…”
The offensively magenta pink form was in front of us on the table. “Physician Order for Life-Sustaining Treatment (POLST)” in bold letters across the top. Our doctor at the Clinic had asked us to think it over and fill it in so they could have it on file for future reference. We discussed it briefly at our last visit. Both my wife and I felt that a strict DNR (Do Not Resuscitate) instruction was our choice. Our doctor tried talking us out of it. She thought it was worthwhile to give caregivers a chance to give back our life should we fall victim to some nasty accident. We agreed to think it over and bring the form back for our next visit. Well, we had talked about it, thought about it, and discussed it with others. In the final analysis we seem to agree that for us, a DNR decision is still the best fit. So I proceeded to fill in the forms and we duly signed our respective copies. Her eyes still focused into the distance, my wife said “What worries me is not having an accident that kills me or nearly kills me – it is not having such an accident. What will happen if, or rather, when, I will have slipped far enough down hill, so that I am no longer capable of doing anything useful or worthwhile, but still breathing? Functioning more like a vegetable than a human being? Will you help me end it if that happens?” |
How to answer such a question? This is precisely the biggest fear for us both. This is why we chose the DNR option on the form, presenting a pathway to sneak out of just that situation. We came to that agreement together, as a team, sharing similar ideals and working toward the same goals. But she is now asking me to face the naked truth without flinching and to decide how I would deal with it without the benefit of an escape route of an accident providing a natural, providential, back-stage exit. It is my turn to take a huge, deep breath. I reach across to squeeze her hand and exhale slowly. “I will, if you will. If I am able…”. She nods almost imperceptibly. And there seems to be nothing else to say.
I gather up the forms, put them in a folder, and head downstairs. Time to get going, my Clinic appointment is in 15 minutes. I get in the car, drop the folder on the passenger seat next to me, and pull out of the lot. NPR’s Science Friday is on, so I turn the volume a bit higher. They are talking about cyber-terrorism, a fascinating topic. I see someone crossing the street at the far side of the intersection, so I slow down to cross it. Something red flashes on the right, I feel a horrendous jolt, a crashing noise, then nothing. Quiet. Darkness. #*#*#*#*#*#*#*#*#*#*#*#*#*# Beep, beep, beep… What is that? I see something green going on and off over on the left. I turn to look. It remains on the left. I turn again. No change. I cannot turn. So I look to the left. Same result. Cannot move. Can I move at all? I lift my arm. No feeling whatever. My leg, my shoulder. Nothing responds. Am I paralyzed? I cannot even blink… |
A nurse gets into my field of vision. I want to ask her what is going on with me. No sound comes out. She is right by the green flashing thing – I now see that it is a monitor of some sort. In my peripheral vision I see various tubes? wires? coming out of it and snaking to me. The nurse is adjusting something, then turns and goes away.
I lay there on my back, totally inert, totally unable to do anything at all, except to think. And to panic. Where am I? Is this a hospital? A hospice? A rehab facility? How long have I been here? What happened? And what will happen? I hear footsteps. A group gathers at the foot of my bed. White coats. Doctors, it seems. One holds a clip board and talks to the group. “This patient had a catastrophic car accident. He suffered multiple spine fractures and is totally paralyzed. He also had significant head trauma, and it appears that he is in a coma. He is being fed intravenously. His major physiologic functions are intact, but it is not clear whether he will ever regain consciousness. Questions?” “No! No!” I want to scream. “I am not in a coma! I hear everything you are saying. I have got to talk to you guys! Help me, please!” But the screaming is only in my mind. The doctor and his students hear nothing, After a brief discussion about comas in general on they go to continue their rounds. I want to cry. This is so incredibly frustrating. No – it is dehumanizing. They think they know what they are talking about, but they have no clue. And I am totally helpless – can’t say or do a thing… I must have dozed off. It is dark now. No sign of life or movement. An occasional stripe of light sweeps through the ceiling as a car passes outside with its headlights on. Is this |
what my life is going to be like from here on? Waiting for another car to pass? Straining to say a word to a doctor, to a nurse, to a visitor perhaps, only to fail again and again?
I hear the door open, and then close again, quietly. A moment later the bedside lamp switches on and my wife’s face appears in my field of vision. Her eyes are red and swollen. She looks exhausted and very, very sad. She looks at me with just a phantom of a smile in the corner of her mouth, while tears are streaming down her face. She whispers “I don’t know if I have the strength to do this, but I promised. So I will try.” With that she steps away. I hear water running. A moment later she is back. She is holding a wet wash cloth which she places on my face. She adjusts it, so it covers my mouth. She puts one hand on the cloth and with the other she pinches my nose shut. As she applies pressure on my mouth, she says “I know that this is what you want. I would want you to do the same if it was me in this bed. I love you.” My dear wife. Yes, we had agreed. If this is not the right time, then what is? What I have here is not a life anyone would want. Yes, I want out, thank you, my dear, for taking this huge risk to help me… For the first time in this condition I experience a physical feeling. Pressure in my chest. I cannot will my arm, or leg, or eyes to move, but my chest muscles and diaphragm move involuntarily, on their own, pumping air into my lungs. But now no air comes. I can feel immense muscle cramps trying to force air to come. Nothing. She now has her face turned away while she is leaning on me, using her weight to seal mouth and nose. My chest heaves. I convulse. I want to scream “Enough! Stop! I am not ready! Go away! What are you doing?!?! Don’t you care? Please! Please! Please…” |