An ancient tenet of medical practitioners is, “First do no harm.” Though widely embraced, it’s not always applied in today’s medicine. Surely such ethics should extend beyond healing and dictate a compassionate ending.
My brother, Jimmy, died around 7:15 pm on Monday, July 25, 2022. I understand why, but I’m troubled by how. Whether it was poor procedures, legal issues, or profit motives, I can’t say. I just know it was wrong.
A massive heart attack around six a.m. on Saturday, July 23rd caused his heart to stop beating. He was shocked then connected to an impella, ventilator, and a barrage of IVs. Jimmy had been hospitalized, except for a brief stay in rehab, since June 13th. He was exhausted physically and emotionally.
His bladder function had been increasingly problematic since March 14th when he fell at home due to a diabetic episode and couldn’t get up. He had tolerated the discomfort of a catheter almost constantly since May 12th.
On July 20th he had emergency surgery for a severely distended abdomen. The surgeon removed two sections of dying colon tissue and performed an ileostomy, leaving him with a bag we hoped was temporary.
The day before his heart attack he sat in a recliner in the ICU for a couple of hours. It was the first time he’d been upright in over two weeks. Saturday’s plan was to walk a few steps but his heart had other ideas.
At best Jimmy was facing a foreboding future with major health issues. He asked me twice, while in the hospital, about a living will. He had asked before but I had procrastinated. From his room I did some online research and found Georgia has a standardized Advanced Directive. But it’s 28 pages, too much to discuss I thought.
So, I’m partly to blame for what I consider inhumane treatment. Shocking him was not the merciful thing to do, but what followed was worse. Regardless of my failure, Jimmy suffered needlessly for two additional days.
An impella, I learned, is a tiny propeller inside a stent that’s placed in the heart via the groin and connects to an exterior pump. Jimmy’s impella was doing about 90 percent of the heart’s work. It’s a temporary device for hospital use only. You can’t take it home.
My bigger concern, however, was the ventilator, not that it was initially employed but that it took two days to have it removed. On Saturday Jimmy couldn’t talk due to several tubes down his throat, but he was alert. Padded mittens on each hand prevented him from pulling the vent out.
For hours he motioned repeatedly to remove it. With medical staff present, I made sure he understood he probably wouldn’t survive without the vent. When I asked if he still wanted it removed, he nodded and clearly affirmed he did.
A nurse, however, told him they really wanted him to try it another 10 or 12 hours. She said additional medication could make him comfortable, so he agreed to the overnight trial.
I spent the night by his bed, but Sunday morning couldn’t get anyone to discuss removal of the vent. They said my request would be made known, and someone would come to discuss the situation. I continued to inquire but no one came.
A second night passed and Monday morning was more of the same. Everyone said they would pass my request along, but at four p.m. no one had come. By then Jimmy could no longer move his fingers or toes and his eyes remained closed.
My wife saw a door with a DIRECTOR’s sign and found an angel wearing a uniform. I told her if there was a possibility of Jimmy improving we wanted to do everything possible, but otherwise he’d been through enough. She was unaware of our dilemma and lovingly attended to my brother. He was disconnected and lived over two hours, long enough to smile briefly at our mother and try to say, “I love you.”
I don’t blame the hospital for Jimmy’s death, but I do fault them for prolonging his suffering. The wishes of a patient with no hope for an acceptable quality of life shouldn’t be circumvented by artificial means. And if the patient agrees to a short trial, the terms should be honored.
It’s unlikely the musings of a small town columnist will bring about change, but I believe the focus of today’s medicine is frequently misdirected. We keep people breathing without considering if it’s the compassionate path. Today’s medicine often fails to practice what has long been accepted as the gold standard of care. “First, do no harm.”
This is so sad, and I understand how hard it is watching a loved one suffer.
Oh Neil, I am so sorry Jimmy had to suffer mercilessly. I did not know the details. 😪
So sorry Neil, that Jimmy, you, and your family had to go through this!!! I know that Jimmy is no longer suffering and smiling down at you!!!!!! God Bless!
My thought are the same with Covie’s death but who amI to say anything except Lord please take him home he is so tired. I didn’t realize the affects his death would have on me. Everyone morning for at least 12 years he would ride by my house with his window rolled down and holler I love you 😢. For several morning after he died I would holler at the nothing coming by. I love you ❤️. You will be in my prayers and keep me in yours
Neil, we are with you about the care for your Brother, Jimmy. We did
pray for Jimmy when you asked for our prayers, we also asked that the
Lord’s will be done, but we can’t believe that it was the Lord’s will
that he not receive proper care in the hospital. We ask that the Spirit
of our Lord and Saviour Jesus Christ surround the family with His
comfort and love. p&B
Neil, this is a very sad and heart breaking bit of information about your brother’s treatment while in the hospital. It appears that both he and you were put through a lot of pain and suffering that most likely was unnecessary. I hope that your information can be shared with many hospitals and doctors. Thank you for sharing this terrible experience with your readers.
God has a plan for each of our lives and it does seem that modern medicine wants to circumvent it! I’m so sorry for such a terrible experience, but glad that you can write about it. This encourages all of us to have a Living Will and make sure our loved ones do. Jimmy was blessed to have you by his side-no one could have done a better job! May the Lord give you peace.
So very sorry for you and the family. My daddy went through something of the sorts but mostly, too little, too late in the hospital. Time and memories of better days of our loved ones help to ease the pain, time being the word, but when our time comes ,sooner or later ,God shows us the bigger picture he had and has for those who know HIM and trust in HIM. You were there all the way for your brother, and it is a learning curve, and causes us to stretch and grow personally as we know now. Time and good memories of the wonderful times you had as brothers through the years will ease the pain…..God Bless
So sorry that Jimmy had to go through all this. There definitely needs to be more humanity in the practice of medicine.
Neil. Just getting around to reading part 2. You are so right and left out many issues in Jimmy’s time spent at the hospital that certainly were not acceptable or humane care! Our system is very dis functional, frustrating and not directed towards the best interest of the patient. One reason I ended up in pediatric nursing is that very reason. Peds is not by a long shot perfect but it is so much more conducive to family centered care and listening to the wishes of the patient and family. I do not know what it will take to “fix” the system. I have a few ideas but for years, there have been the same issues with no action for improvement by the powers to be. Nursing for a caring, dedicated, and old school nurse can be extremely frustrating. This is why so often now we have “people in it for the money”. I am so very sorry you and your family, especially Jimmy, had to endure our broken system for so long!