Class of 2017
“What do you mean his sats are in the 80’s?” I texted to my mother on Friday, May 2, 2014. I was sitting in class when I was informed of just how sick my grandfather really was. I knew he had been taken to the hospital the previous night― but over the past ten years, these visits had become regular occurrences. Grandad had always found a way to bounce back. I immediately made the decision to fly home. I wanted to be there should something happen.
The week before, our school’s bioethics reading group discussed an article by John Hardwig: “Is There a Duty to Die?” I found the piece compelling. In today’s healthcare landscape, why are more of our dollars going to geriatric patients? I was certain that they, who were once caregivers, would be humiliated at how much care they now require. Would it not be more dignified if they just passed away peacefully? These were the thoughts that went through my mind as I discussed the article with others in the reading group. A strong dose of subjectivity was what I had really needed; since my reflections on Hardwig’s article, I have come to understand that end of life decisions are not as black and white as I once thought.
As I was driving home frantically, I asked my mom if I could speak with the nurse who was looking after my grandfather. I wanted to get a good idea of just how sick he was. When she came on the phone, I asked her if I should come home. Her words still ring in my ear: “If you want to see him, you should get on a plane as fast as possible. We have him intubated and sedated. Don’t worry, he isn’t in pain.” My emotions overwhelmed me. I was not thinking about what was wrong with my grandfather medically― I was crying because a loved one was dying.
When I got off the plane, I still had a three-hour drive to get to the hospital where my grandfather was. My mother and aunt picked me up from the airport and the three of use tried to cover the distance as fast as we could. All the while, I was receiving updates on his condition. Even with my rudimentary knowledge, I knew that things were deteriorating. My grandfather was passing away. All I wanted was to be able to say goodbye.
Multiple thoughts struck me at once. If he is beyond saving, is my family prepared for withdrawing life sustaining treatments? Would it be me having that conversation with my father and his brothers? I wanted the medical team to do everything in their power to keep my Grandad alive. I would miss him so much if he passed away.
My dad was there to meet us at the entrance of the ICU. My grandfather had been gone for 15 minutes. He passed away surrounded by his wife of 54 years and two of his sons. I stayed there and said my goodbyes, tears streaming from my eyes.
While I consider myself to be blessed to have had him in my life for 26 years, the loss of my grandfather has had a profound impact on me. I will never think about end of life decisions with the same apathetic outlook I had a week prior. When I am practicing, and it’s the middle of the night, and I am paged for someone I may have once thought has “a duty to die,” I hope to remember that my patient is not just another patient. My patient is somebody’s husband, wife, father, mother― or maybe even a Grandad.
Dr Iain J Robbé
Thank you for sharing these personal feelings. I can empathise with your reactions. I wondered whether your previous outlook was less about apathy and more related to your development based on your experiences up to that time and now your outlook has developed further?
I think that is very likely. Hardwig’s argument was rational, and that is something I have always valued above all else. However, the emotions of this situation allowed me to feel what people go through during end of life situations, and now I have a better appreciation for the difficulty surrounding their circumstances.
Thank you John. It was a difficult time to be sure. Sometimes life has a way of reminding you that things aren’t always black and white. This was certainly one of those times.
Great article Matt. I can relate completely to this experience/your internal conflict in regards to the issue and I am sorry for your loss. Prayers are going out to your family