My feet are on fire…

…but I’m finally home after a very long night at work and I can’t wait to go to sleep and stay asleep until I wake up alone, no alarm, no son and no dog. I don’t remember the last time I did that. I miss sleep…I really do.

I worked on the oncology unit last night and that’s always a bit depressing. I met a lovely lady with whom I’d love to be friends…I gave her my number and I hope she calls me. I spoke to her a LOT last night and she’s just the type of person who would make a great friend for me. We have a lot in common and I really enjoyed speaking to her.

I told her about my cancer and my ex-husband. I also told her about the blog, about when I used to do stand-up comedy, the movies that I’ve been in and even about cheating on the Millionaire test that I flunked. She said that I made her feel like there was hope for her and that made me feel good.

I had a patient last night who’s family was dreadfully unrealistic about her future…to the point of doing EVERYTHING they possibly can do to keep her alive...to a dreadful extreme.


I’ve occasionally come across people that are like that. They’re rare and far between but they’re out there. Usually the patient themselves take care of those decisions before it gets to that point but all too often they never discuss it at all. That’s so sad because when the family has to decide what should be done, there are far too many feelings that go along with the choices that they make.

Rarely does the entire family agree. Leaving such decisions to family members who have to live with those decisions is quite unfair. Whatever they do, there’s always the chance that someone will hold it against them. A grieving loved one may not have the patient’s wishes in mind and they could easily make decisions out of false hope and desperation. (The lady who said that I gave her hope has a reason to be optimistic…the other lady did not.) Leaving such choices to a family who is mourning the inevitable passing of a loved one is sort of asking for trouble. Under the best of circumstances the loved one is left with a horrible decision to make and then they have to live with that choice, as will the entire family.

What I find particularly appalling is a family who goes AGAINST the wishes of the patient. That happens occasionally and it’s an atrocious thing to be a part of. It doesn’t matter what legal documents the patient has left behind, if the next of kin wants to struggle tooth and nail to keep someone alive…they do it. Unfortunately, in our litigious society, the doctors must listen to the person who is still alive and able to hire an attorney. What happens to the patient is absolutely scandalous. It's truly obscene to go to gruesome extremes, but it does happen.

Most people don’t end up on an array of tubes and machines overnight…it’s something that happens slowly and over the course of a long, drawn out illness. That’s why it’s smart to list exactly what you would want the medical people to do for you. For example, one person might want a tube feeding and another might just want IV fluids. One might want a respirator and another just oxygen. Perhaps a person does want all of the possible efforts to be made and another might say, “Just let me go when they come for me.” As unpleasant as the prospect of considering such a subject is, it’s nothing compared to what a family goes through when someone thinks with his or her heart while they should be using their brain.

Most of the time doctors and nurses totally respect whatever decisions the patient and/or family make…but when it goes to an excessive lengths, they start to get a bit appalled. I was a bit appalled last night…as was the doctor that I spoke to this morning.

One thing that I’ve learned is that there’s some degree of ignorance out there. I had one guy who wouldn’t make a decision nor would his family. The entire unit was aware of the difficulty that we were having in trying to get that guy to sign a DNR. (Do Not Resuscitate) The doctor had spoken to the family and they wouldn’t even consider such a notion. Their rationale had to do with their religion...or their interpretation of it. One morning the doc waited until the family left and then he went in to speak to the patient himself. The doctor asked me to go in with him since it was my patient that day and he wanted a witness.

The doctor explained what a DNR was and what the alternatives were. He discussed the machines that the patient would need to feed him, breathe for him, dialyze him and so on. To my horror, the patient asked, “Are these machines too big to carry? Could I fit them in my pocket?” The doctor finally got the point across to him and of course he chose the reasonable thing to do and that was that. Or so I thought.

Right after the doctor and I came out of the room, the man actually did go into cardiac arrest. There was a patient care tech at that end of the hall who was aware of the trouble that we had with the family…but she didn’t know that we had settled the issue. No one did, it had just happened. So, she called a code.

As the code team ran down the hall toward the patient’s room I saw the family coming back. They got to the patient’s room as I was trying to stop the code team from coding that man. They couldn’t understand why I was stopping them. But I had to, it was a doctors order.
That was certainly an extreme case but it illustrates the mentality of some people. These people happened to be hill people…deep, deep in the hills people. But you can find ignorance everywhere.

Maintaining a professional, non-biased attitude is easy enough but it doesn’t change what’s going on. It’s an awful situation to be in, especially when you know that what you’re doing is the wrong thing to do. I just hope that someone gets through to the family of my patient from last night before it’s too late and she ends up on even more machines than she’s on now.

Oh well, there’s nothing I can do about it now. But…I can certainly think about something positive…like my new friend. I hope I get to know her for a long, long time.

Ciao!