It doesn’t have to be this way, and in fact, it wasn’t until fairly recently
She asked me to help her brother-in-law, 75, then a patient in the ICU. He was on a ventilator requiring high levels of oxygen, on dialysis for his acute kidney failure, and on medications to maintain his blood pressure. His wife had signed a do-not-resusciate (DNR) form, and the palliative care team had been called in for consultation. They advised the family to strongly consider hospice care, as there was “at best a one-percent chance” that he would be taken off the ventilator and regain consciousness.
In many cases I’ve witnessed, the transition from ICU to hospice marks the final stage, with patients passing shortly thereafter.
This friend asked me to do whatever I could to help her brother-in-law recover. I reviewed the medical record carefully and found no explanation for why he was doing so poorly. I made some changes in his antimicrobial therapy. I explained all this to the family and told them that although he was very sick, perhaps he could pull through.
Sure enough, within the next two days, his condition had turned around completely. He got off the ventilator and only required a small amount of supplemental oxygen. He started to regain his kidney function. A couple of days later, he began to eat and drink. One week from the time that I first saw him, he was discharged from the ICU and transferred to a regular bed in the hospital, breathing completely on his own.
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