The ambulance crew rolled him into my Emergency Room, breathless, oxygen mask on his face, gasping for air, his cropped hair a mess. Dan was what the staff called a “frequent flyer”. As the nurse injected some IV Lasix I reviewed his chart to find a classic downward spiral. I had vowed that no one would die in my ER if I could help it, until I met Dan and Alice Bruce.
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This was his 6th visit to the ER in the last 15 months. He had a bad heart and it didn’t take much to throw him into pulmonary edema, despite 14 pills and over $200/month in medication each time, he emerged weaker.
I want you to know that each time you come in on the Ambulance is potentially the natural end of your life. We are stopping that with our medicines. If you two have a discussion and decide you would like the next time you come in to be the natural end of your life, I can help that happen for you. I left the room and let them talk about this new option for a few minutes. When I returned she was standing by the bed. Dan spoke. “We want you to help us do that doctor.” I looked them in the eyes and nodded. Both of them were crying in a way that I knew the foundation for their emotions was love.I had them fill out his Living Will and No Code paperwork.
6 weeks later, the call came in. Dan was on his way. Severe respiratory distress. We wheeled him into the room with Alice holding his hand. Dan was barely able to maintain his consciousness, panting with blue lips. They immediately recognized me. I looked at each in turn. They both nodded, Alice stroked his forehead as his breathing worsened. She gripped my hand, looking up to me time to time. It only took 10 minutes for Dan to die. At the point of his last breath, we witnessed his passing, that span of seconds when we could sense his spirit leaving.
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