andsmoking,theirlifeexpectancyoutpacesthenational
mean by a year.
IspoketoGregoryThompson,acriticalcarespecialistat
GundersenLutheranHospital,whilehewasonICUduty
oneevening,andheranthroughhislistofpatientswith
me.Inmostrespects,thepatientswerelikethosefoundin
any ICU—terribly sick and living through the most
perilousdaysoftheirlives.Therewasayoungwoman
with multiple organ failure from a devastatingcaseof
pneumonia,amaninhismidsixtieswitharupturedcolon
thathadcausedarampaginginfectionandaheartattack.
Yetthesepatients werecompletelydifferentfromthose
intheICUsI’dworkedin:nonehadaterminaldisease;
none battled the final stages of metastatic cancer or
untreatable heart failure or dementia.
TounderstandLaCrosse,Thompsonsaid,youhadtogo
back to 1991, when local medical leaders headed a
systematiccampaigntogetmedicalpeopleandpatients
to discuss end-of-life wishes. Within a few years, it
became routine forall patients admitted to a hospital,
nursinghome,orassistedlivingfacilitytositdownwith
someone experienced in these conversations and
completeamultiple-choiceformthatboileddowntofour
crucialquestions.Atthismomentinyourlife,theform
asked:
- Do you want to be resuscitated if your heart
stops? - Do you want aggressive treatments such as
intubation and mechanical ventilation? - Do you want antibiotics?