death and dying

dying, from my perspective, is commonplace. i've grown accustomed to seeing their death look before giving way to His plans. perhaps a few times my heart leaps a second, me wishing that the patient should not have gone that route, but we cannot do anything but surrender to Him.

i say that because once a patient undergoes cardiopulmonary rescucitation, basic life support, or advanced cardiac life support (whichever setting is present), in my experience there is a 50% chance that he or she will die for good. and then those 50% who have been revived will likely have a poor quality of life, in the near-term at least.

evidence-based medicine tells the same story, although much grimmer. as the minutes progress from the point of cardiac arrest, there is about some 30% likelihood that the patient will have survived.

i want people to know this fact because the process itself is difficult for both patients and healthcare providers. just imagine your chest getting squeezed at more than 100x per minute, for 20-30 minutes or so - that's painful. this is probably one reason why we ask their families if they want to put a DNR. if the patient has a poor prognosis of living off inotrope and mechanical ventilatory support in the future, the patient will have a poor quality of life.

although, if i were the patient, maybe i would have wanted my family to continue the inotropes and mech vent for life support - except maybe for the CPR because, really, that must be so painful.

some would confide that people who die suddenly, from a traumatic accident such as an explosion or a road traffic incident, are lucky to have a peaceful death. i concur.

and if i were to die in a slow manner, such as by cancer, i would mull over these options early, so that my family won't have to decide these things for me.