The Art of Caring

Us and Them

Uzma Khan, MD

A 90-year-old woman finds her 95-year-old husband unresponsive on the kitchen floor and calls 911. He is cyanotic and hypoxic when the emergency team arrives. They place him on BIPAP and head to the emergency room. Immediately he codes in the scanner and is resuscitated for 10 minutes. Now he is intubated in the ICU with multilobar pneumonia.

Over the last week, he was increasingly lethargic, had lost his appetite, and slept in his bed most of time. After a week in the ICU, he is not tolerating the breathing trials very well. In comes palliative care. The questions on the table are, “Would a 95-year-old man want to spend his remaining lifetime experiencing a tracheostomy and a feeding tube in a long-term healthcare facility?” and “Is it worth taking the risk of a natural death if he is weaned off the ventilator with no further plans for reintubation?”