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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