hasmadeitalmostimpossibletobesurewhothedying
evenare?Issomeonewithterminalcancer,dementia,or
incurable heart failure dying, exactly?
Iwasoncethesurgeonforawomaninhersixtieswho
had severe chest and abdominal pain from a bowel
obstruction that had rupturedher colon,caused her to
havea heart attack,and put herinto septicshock and
kidneyfailure. I performed an emergencyoperation to
remove the damaged length of colon and give her a
colostomy. A cardiologist stented open her coronary
arteries. We put her on dialysis, a ventilator, and
intravenousfeeding,andshestabilized.Afteracoupleof
weeks,though,itwasclearthatshewasnotgoingtoget
muchbetter.Thesepticshockhadleftherwithheartand
respiratoryfailure aswellasdry gangreneofher foot,
whichwouldhavetobeamputated.Shehadalarge,open
abdominal wound with leaking bowel contents, which
wouldrequireweeksoftwice-a-daydressingchangesand
cleansinginordertoheal.Shewouldnotbeabletoeat.
Shewouldneedatracheostomy.Herkidneysweregone,
and she wouldhaveto spend three daysa week on a
dialysis machine for the rest of her life.
Shewasunmarriedandwithoutchildren.SoIsatwithher
sistersintheICU’sfamilyroomtotalkaboutwhetherwe
should proceed with the amputation and the
tracheostomy.
“Is she dying?” one of the sisters asked me.
Ididn’tknowhowtoanswerthequestion.Iwasn’teven
surewhattheword“dying”meantanymore.Inthepast
few decades, medical science has rendered obsolete