Sara M. Schaefer, MD
- Correspondence to Dr. Schaefer: sara.schaefer@yale.edu
- doi: http://dx.doi.org/10.1212/WNL.0000000000001836 Neurology August 11, 2015 vol. 85 no. 6 553-554
- Excerpt
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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
