bs

     He had tubes and lines going in all directions – oxygen, NG tube, catheter, chest tubes, IV lines.  The attending was with the doctor trying to convince the son that hospice was the best option for his father.  Again.  The son had already agreed once to hospice.  Neither the dad nor son wished him to die while being hooked up to every manner of life support.  He wished to die in his home.  Not so strange really.  I suspect that most people, given the choice, would rather die in the comfort of their own home rather than surrounded by tubes, beeping machines, and the constant interruptions by the staff.  But the son was confused and uncertain and changed his mind several times.  His dad was dying and the decision rested solely on his shoulders.  Wasn't hospice a form of giving up?  Couldn’t he recover if he just got the right care?  What should I do, doctor?

     While this conversation occurred, I went over to see if the patient needed anything.  He had a bit of applesauce on his chin left over from his comfort feeding.  I gave him a paper towel and helped him wipe it off.  He stared at me for several seconds and stated in a very calm and straightforward manner, “have you ever seen such BS?”  I asked him what was the BS, but by that time his delirium had returned and he shrugged his shoulders unknowingly.  I will never know for certain if he was fully lucid at that moment.  Whether it was the ramblings of an altered mind or the questioning of a dying man, it did not seem to matter.  His question cut to the heart of the issue at the end of life.  Tubes everywhere.  Different doctors wanting so many different things, often mutually exclusive.  And none of it addressing the issue put forth to the patient and his family, “You have a limited time left on this earth.  It may be days, it may be weeks, it may even be a few months.  But the end IS near.  How would you like to spend it?”  So much BS, indeed.