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Hi TL.
It's been one hell of a long time.
First of all, apologies for the long absence. I've had a massive workload lately and I haven't been able to write in my blog or play as much SC2/cast games as much as I wanted. Now that my voice is all screwed up, I can't cast either :C...
Buuut... Since I'm sick with laryngitis and my doctor put me on sick leave for 10 days, since, as he said "you're a doctor and your main tool is not your brain, it's your voice, and if your voice isn't good, you're worthless, so you're hereby forbidden to talk until further notice, and thus, TAKE A FUCKING SICK LEAVE, FFS!"... So I'm now home with a speech ban upon me, hence I'm boring sick, so I've been playing a lot of ladder games, checked the HoTS beta, and thought to write about my last ER case, as I usually do.
This was yesterday, on my last shift. I had been sick for over 10 days, and I was refusing to give up my ER shift, so I went to work with the shitty little voice I had left.
An uneventful morning was going on. I had seen about 40 patients when we had a phone call from the EMT dispatch centre.
We've got a call for an elderly woman who's unresponsive at her home; next of kin is providing CPR. EMTs arriving to scene.
I then preppared everything at the reanimation box in the ER for what seemed to be a cardiac arrest. My gut call was confirmed a couple minutes later by the EMTs calling on the radio.
Doctor, be advised: Were inbound with a 92 years old female, hypertensive, BP 180/110, pulse slow but steady at 40 bpm's, saturating at 95% with 2 litres per minute of oxygen, who collapsed at her home; recieved CPR from relatives for reported missing pulse upon first attention: patient currently with good vitals.
So, patient was sort of stable...
She enters the ER 2 minutes later. When I saw her, my heart sort of shrunk.
She was a little old lady, looking very, very frail... A little pale, with white hair; very thin, in an odd sort of lateralized possition... Seconds later, her family arrives. I send a nurse to gather some data.
As soon as she leaves the room, we connect the patient to the vital signs monitor. Nothing weird so far...
Her physical examination had a few things to note.
Upon examining her chest, she had noises in her lungs that suggested fluid was being gathered in them. I ordered to push an amp of Furosemide, a medication which helps the kidneys get rid of excess fluid in the body. Her extremities had oedema, which is basically swelling due to retained excess fluid. And last but not least, when I examined her heart, I heard a murmur at the mitral valve. You see, the heart has 4 cavities: Left atrium, right atrium, left ventricle and right ventricle; there are 4 valves, acting as gateways between atriums and ventricles, and ventricles and major blood vessels: The tricuspid valve, the gateway from the right atrium to the right ventricle; the pulmonary valve, from the right ventricle to the pulmonary artery; the mitral valve, from the left atrium to the left ventricle, and the aortic valve, from the left ventricle to the aorta.
The mitral valve recieves that name because it resembles a bishop's mitre...
![[image loading]](http://cdn.aquinasandmore.com/images/items/damascene-bishops-mitre9121lg.jpg) A bishop's mitre.
This particular murmur is called the "mitral regurgitation" murmur, since it sounds like blood is being pushed back to the ventricle. It usually means one of the valve's leaflets has dropped, being leaky. In a patient like this, I had to think of a very particular reason: One of the muscles which control the leaf had been damaged, most likely from a myocardial infarction.
![[image loading]](http://www.heart-valve-surgery.com/Images/mitral-valve-anatomy-1.jpg) TL; DR the last paragraph: The old lady had THIS in her heart.
I then ordered an EKG and some blood tests.
Her EKG was taken in a minute. I inmediately took the paper strip from the machine. It looked like this:
![[image loading]](http://www.portalesmedicos.com/imagenes/publicaciones_2/0909_ECG_IAM_IMA/supradesnivel_ST_infarto.jpg) Oh, fuuuuuuuuuuuuuck...
Upon seeing the EKG strip, I looked like this:
![[image loading]](http://illblogthereforyoublog.files.wordpress.com/2012/03/carter.jpg?w=523) Yeah, I was not amused.
Note: Any likelihood between Dr. Carter and myself is a coincidence.
Grim. She had a MASSIVE heart infarction.
I went outside to speak to her family to break out the bad news...
Both her daughters were there. I knew one of them, which happened to be an EMT at my hospital: she retired 3 years ago. She was the one who gave her mother CPR.
So I told them what her mom had.
Then the former EMT asked for a while alone to discuss the subject with her sister. I went back inside the reanimation box to attend my patient and told them I'd be back in a couple minutes.
I then ordered 3 miligrams of morphine to be pushed IV, a drip of labetalole to be installed and to up her oxygen a little while we waited for the blood tests, and asked for a bed to be prepared for admission.
A few minutes later, the nurse comes back in... Tells me the old lady's daughters wanted a word with me.
They basically told me this:
Doctor, we're very grateful for everything you're doing for her... But she's so old. Her heart is giving in, and we'd like to respectfully refuse any treatment you want to prescribe for her right now. She's lived her life and we don't want her to die in a hospital, visitors restricted, maybe alone and without her family and without her things... We'd like to take her home, and we understand what it means to refuse treatment, but we don't want her to be admitted and to die here...
I was so moved I had a hard time handling my emotions. But I understood. I thought of my own mother, if she were that old... And I totally got in their shoes.
If you truly understand what taking her home means, I have no objections... You'll have to sign a release authorization, a do not resucitate order and a do not treat order... I understand what you're thinking and I fully support your call...
Then, the former EMT said 9 words that have been ringing in my head ever since.
"Doctor, thank you for letting my mother die well."
After signing a few forms, they took their mother home.
I broke upon seeing them leave. A colleague of mine who was leaving the residency saw me on the hallway, hands on my face, crying...
"What happened, man?"
I told him this story. With my almost non-existing voice.
He told me this:
"Look man, I know letting go is very emotional, but they have been strong enough to face death with a grin... You should too... And get yourself home, damnit, you can't even speak and you still want to work here... You must really love the ER, but you've got to look after yourself, too... Go home, get some rest, call an Otorhinolaryngologist and get your throat checked, man... I'll handle your shift.
I then went home... And have been thinking of those words.
We truly don't value the dignity of death. We sometimes don't see how important it is for people to be surrounded by their family, to be within their home, in their bed, during their final moments. Hospitals should be a place for people to get better... Not for them to go dying. The bravery with which the family of this patient faced death was admirable.
I wish to have that strength the day one of my folks goes away.
I want my kids to have that strength when I go, too.
Thank you for reading.
 
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I think the phrase "T_T" summarizes this blog entry pretty well.
Being an ER doctor is one of the most emotionally taxing professions I can think of, but at the same time it can be so inspiring to see bravery in the face of death.
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A very touching story, thank you for writing about your experience.
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thank you so much for sharing the valuable story.
are you an EM doctor?
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When you spend ten, maybe fifteen years of your life dedicated to a cause, not just a goal, but something that is rooted outside of you, as emergency medicine is (to be prepared and capable of saving whomsover needs to be saved), your self identity becomes wrapped up in that cause. You define yourself by your ability to do your job. Even in this one post you ooze that from the detail of recollection to the sig-quote you use.
It's a psychological hallmark of historical great people that they suffer from this identity-becoming-ideal effect, but it's also a hallmark that they tend to sense the strange, playful core of such causes and, while capable of erasing all aspects of themselves other than the pursuit of that cause, they can if need be exorcise the little part of themselves that thinks and let it rest outside that identity for a while. They can see themselves as characters in a story, they can see their place not from within, but without. Just like children playing a game.
On the few occasions I have managed such a thing, it has done me a great deal of good. I avoid offering empathy or sympathy because, well, you don't need to be told how you feel, and I'm sure you know other people get it anyway. So that's all, just an observation.
Hope the throat comes through. In the interests of completely switching tone and busting out the irony, hot water, lemon juice, dissolved honey. Never failed me yet. Reality be damned, it tastes good.
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On November 14 2012 13:09 Thereisnosaurus wrote:
Hope the throat comes through. In the interests of completely switching tone and busting out the irony, hot water, lemon juice, dissolved honey. Never failed me yet. Reality be damned, it tastes good.
It tastes really damn good.
No luck for the throat for a week of hot water, lemon juice and dissolved honey, but reality be damned, I'll still be drinking lots of that joyful mixture because fuck yeah, it's a very damn good and tasty beverage.
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shit, its been a while since i've cried. thanks, and good luck with your voice
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Amazing story, wow :/
So much respect to you, and as always, thanks for sharing.
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It's a poignant point you make, I haven't thought about this much myself, but it does require great courage to acknowledge death, in order to face it how you want. I, too, hope someday to be able to act similarly. A very compelling story, thanks for it!
Oh, and I hope your voice gets better man!
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otorhinolaryngologist, say that three times fast ... actually, just say it a single time at a medium pace.
gl with the voice and thanks for all your hard work.
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As always, your blogs are inspiring. Welcome back >.<
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Thanks for sharing - hope you get some relaxing done on your leave 
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TLADT24920 Posts
Touching story, hope you recover and get back to doing what you love 
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eh, what? What did the mom have to say about it? Wouldn't it make sense to try to revive her and then ask?
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Aotearoa39261 Posts
Every one of your blogs are amazing. This has kinda left me speechless, so I'll just say this. Get well soon
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So touching... And so brave to face the truth head on...
(Also yours is definately the best blog around here. Thanks)
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How do you manage to go through so many emotional experiences and still stand tall?
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Interesting blog post =)
I'm currently an intern in an Australian hospital. I'm not familiar with the patient demographic in Chile but here in Australia the average patient age is 80 years old.
We frequently have issues with decisively managing elderly patients with multiple comorbidities. In most cases their family do not help us formulate a proper directive. Often they have unreasonable expectations for recovery and wish for life-prolonging treatments to be given on a regular basis. We often have a 'not for resuscitation' order filled out, however usually our supportive treatments such as IV fluids and antibiotics are enough to stabilise a patient to a degree where they're safe for discharge. At home they decompensate and represent shortly thereafter for some other acute-on-chronic medical issue.
Personally I feel uncomfortable about this, as I see these elderly people become institutionalised and spend the last years of their life coming in and out of the hospital like a revolving door in a hotel lobby, losing their dignity, sense of identity and independence in the process.
I understand how you feel in this situation, however I personally feel different. Try to see the bright side, at least this case had a clear management goal and you were able to recognise it and work towards it. It goes against our basic training as doctors to let some one with such a serious medical issue be untreated, but in many instances (such as this) I think it is for the best.
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Another touching story from you. I admire you deeply man, and I'm not the only one.
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if reading is mastication for the mind, this blog is a healty gourmet dish with ingredients straight from the soil, unlike the typical chocolate candy bar blogging that goes on. It is emotionally challenging but thematically wholesome.
I'll be looking out for these blogs from now on. thank you doctor for making the world a little better. go doctors~!~
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Otorhinolaryngologist
So that's the proper term for a ear nose throat doctor.
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On November 14 2012 19:00 UniversalSnip wrote:
eh, what? What did the mom have to say about it? Wouldn't it make sense to try to revive her and then ask?
The mother was unconscious. Heart insufficiency was enough to put her into deep sopor and compromise her consciousness and judgement. I'd say it was expected after having half her heart muscle dead by an infarction.
Otherwise, it's pretty obvious the patient has the final call. It just wasn't the case this time.
On November 14 2012 13:05 phosphorylation wrote:
thank you so much for sharing the valuable story.
are you an EM doctor?
No, good sir. I'm a general practicioner working in a small countryside hospital in southern Chile. I'm too young to be a specialist yet, I'm only 26 and have been practicing for a year and a half, maybe a little more. I just happen to like the ER so I tend to pull some extra shifts out of my colleagues. There are 4 of us here and we pull 24-hour long shifts, sometimes up to 3-4 times a week, and the rest of the days we just do clinic duty.
I'd also like to thank you all for your kind words and 'get well' wishes. My throat is still fucked up but I'm confident that with the speech ban imposed on me by my ORL, it'll get better soon :D... I just have to endure the wishes to cast some sick SC2 games I've seen these days :C
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Love your Blogs. I'm currently in an RN program with hopes of working in the ER.
Thanks for Sharing. Also you wouldn't mind me asking what doctors usually think about Male Nurses. All I've heard about is horror stories and alot of discrimination. PM me if you'd like.
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My grandfather had cancer and we brought him back too as it was clear that he will
very soon...
They gave him a lot of painkillers, morphium etc and as i visited him for the last time
he was lying in his bed. I cried badly and he had tears in his eyes so I think
he still recognized and it was a dignified dead beside his family
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On November 15 2012 00:10 meteorskunk wrote:
if reading is mastication for the mind, this blog is a healty gourmet dish with ingredients straight from the soil, unlike the typical chocolate candy bar blogging that goes on. It is emotionally challenging but thematically wholesome.
I'll be looking out for these blogs from now on. thank you doctor for making the world a little better. go doctors~!~
This is a beautiful characterization of this blog.
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Great story, thank you for sharing. The profession you have is not one that is difficult, both emotionally and intellectually and I have a lot of admiration and envy for people who have the bravery and dedication to pursue this as a career path. Thanks again, hope to read more of your blogs soon!
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wow.
i just about broke into tears in the middle of class.
i'm so sorry, dude :c i can't imagine ever having someone else's life in my hands.
get well soon. <3 amazing blog.
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My eyes almost got teary, too after reading this.  Partly because my mom and I almost died from a car accident. Accepting death is probably the hardest part in life.
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Umbra,
As a pre-medical student, I would like to sincerely thank you for sharing this inspiring story. It was like looking through a window into what doctor's have to face daily.
Thank you for sharing.
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On November 15 2012 08:52 Korson wrote:
Umbra,
As a pre-medical student, I would like to sincerely thank you for sharing this inspiring story. It was like looking through a window into what doctor's have to face daily.
Thank you for sharing.
You're welcome.
In pre-med you might not really get all that's going to go through your daily work in the future.
Talk to a physician, maybe one of your teachers. Besides the subject they teach you, they can also provide invaluable work experience and that prepares you a lot more than reading a whole book's chapter.
Good luck through pre-med, sir!
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Excellent read.
Helping people; psychologically and arguably, it's the most rewarding and self-satisfaction thing you could possibly get. It absolutely doesn't matter what your job is (whether you're a doctor, repairman, salesman), nothing beats the satisfaction of seeing a smile on someone's face and receiving a 'thank you'.
Saving lives ranks the highest in the Maslow's pyramid. Gives the highest mental reward one could imagine, which is why people like you, strive to save people.
Healing Hands.
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Get well soon and keep us updated on these awesome stories
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As an update on me, my voice is getting better! I can now speak without sounding like a robot! 
Still, since I can't speak too much, I've still got 2 days of speech-ban to go through. Writing what I want to say to my folks at home sucks :C
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Boring blog.....when are you guys gonna write about something exciting like knocking out a Tiger with a choke hold while on your vacation in Africa ?
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On November 16 2012 01:51 GermanWarHero wrote:
Boring blog.....when are you guys gonna write about something exciting like knocking out a Tiger with a choke hold while on your vacation in Africa ?
Oh, I'm sorry.
Maybe when I actually get on a vacation (still 3 months away for the 1st one in 3 years). And don't worry, I won't waste my vacation going to Africa to beat the shit out of a tiger (even though I'm struggling to think where in hell will I find one in AFRICA). I'll go to an MLG or maybe Dreamhack. Or maybe both. I don't care if I have to travel the 7000 miles separating Chile from the USA or a couple thousand more miles from Europe to see some quality esports.
So I'm sorry to disappoint you, but you won't see that shit on my blog, son.
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I have a question, I'm assuming the patient was unconscious or cognitively impaired or something? I ask this because the family made the decision to "limit" treatment on her, is this something usual? I'd guess you need the patient's approval for this right?
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Your blog posts have been absolutely amazing. Don't stop sharing this with us. Each one has been a gem and rush of emotion. Keep doing what you're doing and take care of yourself. You can't help people if you're dead.
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On November 16 2012 02:27 mordk wrote:
I have a question, I'm assuming the patient was unconscious or cognitively impaired or something? I ask this because the family made the decision to "limit" treatment on her, is this something usual? I'd guess you need the patient's approval for this right?
If patient is unconscious or unable to make a call, and a treatment desicion is critical and has to be taken by the moment, the patient's next of kin can take it.
If the patient had not been unconscious, and she had been lucid and in her right mind, she can make that call herself. However, this was not the case. In deep sopor and with her consciousness compromised, that call cannot be taken by the patient.
BTW man, weren't you in your last year of internship? How are things going? Feel free to PM me.
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Very inspiring story, thank you for sharing it.
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On November 16 2012 01:51 GermanWarHero wrote:
Boring blog.....when are you guys gonna write about something exciting like knocking out a Tiger with a choke hold while on your vacation in Africa ?
Where's he gonna find a tiger in Africa?
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On November 16 2012 04:42 nebula. wrote:Show nested quote +On November 16 2012 01:51 GermanWarHero wrote:
Boring blog.....when are you guys gonna write about something exciting like knocking out a Tiger with a choke hold while on your vacation in Africa ? Where's he gonna find a tiger in Africa?
Exactly xD
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Every time I read your blogs I feel so many emotions.
The fuck, how are you a doctor and not a writer. 5/5
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On November 14 2012 12:43 UmbraaeternuS wrote:Hospitals should be a place for people to get better... Not for them to go dying.
damn...
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Love the moral at the end.
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On November 16 2012 08:16 Antimatterz wrote:
Every time I read your blogs I feel so many emotions.
The fuck, how are you a doctor and not a writer. 5/5
TY sir. I happen to write a little, but despite all the blog critics I think I'm a lousy storyteller. I like to write poetry most of all, but it's in spanish, so meh.
On November 16 2012 08:34 Diglett wrote:
damn...
Oh, you know what I meant... People are often almost "abandoned" in a hospital by their family because of the fear death induces in all of us. Some others go themselves when they are near the end. I don't say ALL people should die in their homes, since there are obviously some cases in which that is not possible... But hospitals should be a place of recovery, not a place to go lie down in your final moments, in a foreign environment, surounded by strangers. It's just that. Death should be a dignified thing, faced with courage and embraced instead of frowned upon... But the current conception of death and severe illness as something that should be left alone and put apart is, at least to my point of view, almost inhuman.
On November 16 2012 12:36 Glenn313 wrote:
Love the moral at the end.
Thank you, sir. I was merely expressing my thoughts on a touchy subject, I'm glad you liked it.
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Thanks for sharing this story,
I have the utmost respect for you, doctors.
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Its always a hard thing to be the one talking to the family as a love one goes away but man those girls did great and i hope many familys would do the same, since theres no reason to have a person on ventilators and amines if they can go home and get some last few hours with their family, Hope you get better
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Oh my god ):
Put me to tears it did.
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I hate to be the partypooper and I would like to preface this by saying that it is not to knock on your professionalism but rather the idea of blogging about stuff like this.
It seems to me like you gave up prematurely on the treatment, but there are probably a lot of details you are not sharing (for obvious reasons - the oath of silence should not be taken lightly and this is a public forum). Still, the prevalence of mitral regurgitation is around 2% in the elderly population, making it one of the most common heart defects (and the edema of the legs makes it very plausible that it was present before the heartattack) and apparently the only other indicator you had of severity of the attack was the ECG showing a STEMI. Which to top it off is a diagnosis with a pretty good survival when the patient is stable upon arrival at the hospital. The mortality increases rapidly by delay of treatment though, begging the question why in the world she was not sent to PCI almost immediately or at the very least had thrombolysis if you do not have the facilities to provide PCI within 90 minutes.
Oh well, this is exactly why I gave up on medical series in the television - lack of details. The moral of the story is decent enough, I just think the case is lacking greatly for it to be justified.
Good luck with the throat and happy nerdslaying
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On November 17 2012 12:02 Ghostcom wrote:I hate to be the partypooper and I would like to preface this by saying that it is not to knock on your professionalism but rather the idea of blogging about stuff like this. It seems to me like you gave up prematurely on the treatment, but there are probably a lot of details you are not sharing (for obvious reasons - the oath of silence should not be taken lightly and this is a public forum). Still, the prevalence of mitral regurgitation is around 2% in the elderly population, making it one of the most common heart defects (and the edema of the legs makes it very plausible that it was present before the heartattack) and apparently the only other indicator you had of severity of the attack was the ECG showing a STEMI. Which to top it off is a diagnosis with a pretty good survival when the patient is stable upon arrival at the hospital. The mortality increases rapidly by delay of treatment though, begging the question why in the world she was not sent to PCI almost immediately or at the very least had thrombolysis if you do not have the facilities to provide PCI within 90 minutes. Oh well, this is exactly why I gave up on medical series in the television - lack of details. The moral of the story is decent enough, I just think the case is lacking greatly for it to be justified. Good luck with the throat and happy nerdslaying
Yes. It was a STEMI, but here PCI is unavailable. The nearest cardio-angio centre is 400 kilometers away. Thus, thrombolitic therapy should have been started, and OFC there are other things I didn't state, such as the fact that the patient was under anticoagulant therapy because of a deep-vein thrombosis that she had a year ago, AND being hypertensive, which are relative counter-indications for thrombolysis, so at that risk, the treatment and admission were at the hands of the family, via an informed consent form... Which they respectfully declined to accept.
Also, as the daughters stated, no prior history of heart conditions nor murmurs were known. Generalized oedema was present only the day before the episode which brought her to the ER. She usually had oedema in her lower extremities because of the venous insufficiency which led to her DVT in the first place.
Also, I think it's pretty safe to say not many folks actually understand what's going on here in the depth that you do. Let me just state that it is because of that precise fact, and the oath of silence, that I don't like to tell too many details. And it is precisely because of that lack of details that your judgement on this is so biased. You don't have the whole picture, and therefore your whole post is, at least to my eyes, some flame attempt which is completely out of place, instead of an 'informed' case discussion among peers, which is NOT going to happen here, because it's neither the time nor the place.
The moral is why I shared this story... And it's, at least to my eyes, pretty much justified.
Not to yours, ofc. Partialized information and bias have blinded you to a poignant and wrong conclusion.
And thank you. Throat is doing ok and not much nerdslaying going through ATM, mostly reading and watching movies.
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On November 17 2012 13:02 UmbraaeternuS wrote:Show nested quote +On November 17 2012 12:02 Ghostcom wrote:I hate to be the partypooper and I would like to preface this by saying that it is not to knock on your professionalism but rather the idea of blogging about stuff like this. It seems to me like you gave up prematurely on the treatment, but there are probably a lot of details you are not sharing (for obvious reasons - the oath of silence should not be taken lightly and this is a public forum). Still, the prevalence of mitral regurgitation is around 2% in the elderly population, making it one of the most common heart defects (and the edema of the legs makes it very plausible that it was present before the heartattack) and apparently the only other indicator you had of severity of the attack was the ECG showing a STEMI. Which to top it off is a diagnosis with a pretty good survival when the patient is stable upon arrival at the hospital. The mortality increases rapidly by delay of treatment though, begging the question why in the world she was not sent to PCI almost immediately or at the very least had thrombolysis if you do not have the facilities to provide PCI within 90 minutes. Oh well, this is exactly why I gave up on medical series in the television - lack of details. The moral of the story is decent enough, I just think the case is lacking greatly for it to be justified. Good luck with the throat and happy nerdslaying Yes. It was a STEMI, but here PCI is unavailable. The nearest cardio-angio centre is 400 kilometers away. Thus, thrombolitic therapy should have been started, and OFC there are other things I didn't state, such as the fact that the patient was under anticoagulant therapy because of a deep-vein thrombosis that she had a year ago, AND being hypertensive, which are relative counter-indications for thrombolysis, so at that risk, the treatment and admission were at the hands of the family, via an informed consent form... Which they respectfully declined to accept. Also, as the daughters stated, no prior history of heart conditions nor murmurs were known. Generalized oedema was present only the day before the episode which brought her to the ER. She usually had oedema in her lower extremities because of the venous insufficiency which led to her DVT in the first place. Also, I think it's pretty safe to say not many folks actually understand what's going on here in the depth that you do. Let me just state that it is because of that precise fact, and the oath of silence, that I don't like to tell too many details. And it is precisely because of that lack of details that your judgement on this is so biased. You don't have the whole picture, and therefore your whole post is, at least to my eyes, some flame attempt which is completely out of place, instead of an 'informed' case discussion among peers, which is NOT going to happen here, because it's neither the time nor the place. The moral is why I shared this story... And it's, at least to my eyes, pretty much justified. Not to yours, ofc. Partialized information and bias have blinded you to a poignant and wrong conclusion. And thank you. Throat is doing ok and not much nerdslaying going through ATM, mostly reading and watching movies.
I might not have come off clearly in my first post seeing how defensive you have gotten. My point was not that you acted wrong in any way - in fact I think I made it quite clear that I assumed that you acted correctly based on information you for obvious reasons could not, and should not share on a public forum.
Let me reiterate this, because it seems like this is the basis of your defensiveness and apparently I was not clear enough in my first post: I do not wish for more details, nor do I wish for a peer discussion, this is a public forum and detailed information should not be provided in such an environment.
I do not have the whole picture, and for that exact same reason I did not pass any judgement on you which I think you will notice if you go back and read my post with an open mind - if not, my apologies.
I will stand by my conclusion though: When blogging about stuff like this, one should exercise extreme care so as to not give the wrong picture of the basis on which doctors generally make decisions. Less than 6 months ago we had a case in Denmark where a documentary mistakenly portrayed how people are declared brain-dead and thus eligible for organ donors (to top it off the doctor in that case actually made a mistake). This has lead to a massive amount of people retracting their consent to be organ donors - which for obvious reasons is problematic.
Take from this what you want, but it sure as hell was not an attempt to flame.
To brighten the mood a bit I will leave you this which for some reason always makes me smile:
+ Show Spoiler +
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My favourite blog on TL.
Dying well is something I've been thinking about a lot recently. My grandmother died last month, she had a lung condition so dying at home wasn't really an option or she'd have died within minutes of asphyxiation. But as much as the hospital can do to make the death as peaceful and dignified as possible there is something a little cold to dying in a hospital.
I guess we can't all have that perfect Hollywood death where you say goodbye to your loved ones and then close your eyes and drift off.
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EPT![[image loading]](http://rlv.zcache.com/i_found_this_humerus_postcard-p239901625585053869baanr_400.jpg)
