Reflections: Neurology and the Humanities, Caring for Maggie


 

 

Sara M. Schaefer, MD

  1. Correspondence to Dr. Schaefer: sara.schaefer@yale.edu
  1. doi: http:/​/​dx.​doi.​org/​10.​1212/​WNL.​0000000000001836 Neurology August 11, 2015 vol. 85 no. 6 553-554

    Finally, a real person to talk to me.

    “Hello, I’m Dr. Larson. Are you a

    family member of Ms. Brown?”

    I hope the nurse is paying

    attention to her blood pressures.

    “I’m Bill, Maggie’s husband.”

    Please tell me she’s going to be OK.

    “It’s nice to meet you, Mr. Brown,

    although I’m sorry it is under these

    circumstances. I’m an intensive care

    doctor who is caring for your wife.

    What do you know so far about why

    she’s here?”

    How do I tell you that she’s not

    going to be OK?

    “Our neighbor told me she found her on the

    ground and called 911. That’s pretty much all I know.”

    I’m not ready. I’m not ready for this.

    “Unfortunately it is very serious.

    I’m so sorry to tell you that your

    wife has had major bleeding in

    her brain.”

    I’m sorry that I have to break your heart.

    “How could this have happened? I just saw her this morning.”

    Why didn’t I call her at lunch. If only I’d checked on her, this never would

    have happened.

    “These things happen all of a sudden.

    It’s no one’s fault.”

    You remind me so much of my father.

    I can see him sitting here, as devastated

    and bewildered as you are. He would be lost.

    “Is she going to be OK?”

    Why isn’t my son here? He would know

    what to do.

    “I’m afraid it’s a large amount of

    bleeding. There is significant

    damage to the brain.”

    If only I could save her.

    “Well, can’t you stop the bleeding

    somehow? Take the blood out?”

    I don’t understand.

    “The bleeding likely has stopped,

    but will continue to cause problems

    because of swelling of her brain inside

    her skull. If she survives, she will likely

    be severely disabled.”

    I can see her in a coma in a month,

    with a trach and feeding tube, warding

    off her third pneumonia.

    “So what do we do now? There must be

    something you can do.”

    I refuse to let this be the end.

    “We can go in a few directions. We can

    be very aggressive with her care, which

    may keep her alive, but won’t reverse the

    large amount of injury that has already

    occurred. Or we can focus on her comfort.”

    I don’t want to break her ribs with CPR.

    That’s no way to die.

    “Do everything you can.”

    You’re giving up on her. I can feel it.

    “Have you ever had a conversation

    with your wife about what she would

    want in this type of situation? Does she

    have a living will?”

    If only you knew how peaceful comfort

    can be, in the end. For her and for you.

    “No. I don’t know.”

    We never talked about these things.

    It was too scary.

    “The important thing is to focus on

    what she would want.”

    He doesn’t understand.

    “Please save my wife.”

    Miracles happen every day. Please God

    send a miracle.

    “We’ll do everything we can for her.”

    I wish I could give her peace.

     

     

    Footnotes

    • Listen to Dr. Schaefer read this poem, available on the iPad® and Android devices.

    • © 2015 American Academy of Neurology

    CONTINUE READING….

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