 A man does not die of love or his liver or even of old age; he dies of being a man. ~Percival Arland Ussher We had just returned from a birthday dinner for my brother.
Then Amy
got called about her favorite uncle. He
had been on "life support" in the hospital for a couple days with no
signs of consciousness or improvement. They
were going to "pull the plug" today, in an hour. "Whatever
you want to do," I told Amy. The
hospital happened to be a half hour away.
Mapquested it. Then we left. I didn't know Uncle Teddy that well personally.
I'd always see him at Amy's family get-togethers though. He was the only white
guy there (I was probably the "other white guy" to many), but he was easily one of the most beloved family
members. He was a big gentle teddy bear; quiet and encumbered somehow, but always a warm and fuzzy presence. Because of him, Amy's entire family was able to come to the United States, from Corea. Uncle
Teddy had been on a breathing machine for most of the past year due to a massive
stroke. Pneumonias, mucus plugs, the
usual ventilator-dependent bouquet from 1-800-VEN-TIL8. He had been at my hospital enough times that I
saw his son more at work than outside of it.
"He
looks like he lost weight," I say in the waiting room to his son, a
mountain of a man who has his father's presence. "Yeah,
people say that, but I can't tell," his son answers.
He and his sister are half-Corean as well. They have more than
their share of demons to fight, and crosses to bear. Or maybe
it's the other way around. Uncle
Teddy is on the ventilator, in the smallest ICU room I'd ever seen, in probably
the smallest hospital I've seen since … the last time I was here. Ten
years ago, I interviewed at this
hospital as practice for the residency programs I really wanted.
Every hospital is basically the same to me, a hospitalist. Psych
on top, morgue on the bottom. The only difference is where the
deck is cut in the middle. Walking into the room of a critically ill patient with
several family members present is always stressful, when you are The Doctor. Lots of tears, tempers, time, questions, and
sometimes thinly veiled threats all get directed at you because you can or can't do something about everything. As
a
visitor, this was ... easy in comparison. I'm not part of the
machine this time. I'm just a ghost in the machine. I look at
the vent settings. Low oxygen requirement. Not much resistance. Not breathing above the set respiratory
rate. His lungs were probably fine. His brain being without oxygen for over
fifteen minutes (or even over five) would not be fine. On team rounds, with his complicated medical
history, you might sum him up as "poor substrate" to begin with. Amy is a
little teary-eyed. Just
don't say it in front of the family. Outside
the waiting room, I see residents on-call, young and tired and with sick people
to see. They pass detached glances toward
our crowd in the waiting room. They're
glad that this huge family isn't here to see one of their patients. At least, no one is screaming or yelling in the halls. Someone
in the family asks me if an autopsy could determine if the brain was oxygen
deprived for ten minutes versus an hour.
The litigious question nauseates me a little. But I answer that I don't think so, and I
honestly feel it doesn't matter either way.
Poor substrate dictates poor fate. Eventually,
they "pull the plug." What
they, and by they, I mean the respiratory therapist, actually do is pull the
breathing tube out and then turn off the machines. After that it's up
to the patient to breathe on his own. Amy and I
were guessing hours, but people aren't clockwork. "He
didn't look that bad," Amy tells me outside as I gather the kids, "He
was still calm. His heart rate and
respirations are still the same even off the vent. He
might last a while." Amy hasn't been an ICU nurse for seven
years, but calibrating life and death is still second nature. And
a comfort somehow. Eventually
we leave. The kids are tired and
uncharacteristically subdued. We're just visiting, we say. Amy tells me new memories,
"We
used to spend all summer at his house with our cousins when we were
little. "He
was a policeman in the country. I looked at his police
reports once. They were
mostly just people seeing bears..., "He worked in a factory. The machine room was so loud, sometimes he would yell at the top of his lungs just for fun
and no one could hear," Amy chuckles, "He thought that was funny." Even with the machines turned off, we still can't hear him. "I'd
like to see a picture of him and his wife when they were younger," I
say. We were
watching the new 007 movie the next day when Amy's phone buzzed. The line was busy,
but back in the theater, she knew what the call meant. Most people don't cry during the action scenes.
____________________________
 My girl Ooseung has the "playing hard to get" act down pretty well. Sometimes her guard is down though.  Picture
above taken at Corean Celebration Day at our local library. This
was a classic samulnori ("four instruments") demonstration. Sun
Su is the one with his hands over his ears (green shirt). The
bigger drums represent thunder but it's the cymbals (representing
lightning) that get excruciatingly loud.
EMAIL: scott_to_trot[at]msn[dot]com |
