Wrestling with the decisions of DNR, and, finally making it, and, how the family members, dealt with letting their loved ones die, translated…
That Period of “Hard to Let Go”, the Considerations, the Getting Torn in Between, Symbolized the Hardest, and the Bravest Moments of Our Lives…
Those who hadn’t made such a difficult decision, shouldn’t judge other’s decisions which such cruelty, this is, what I’d, humbly learned, from accompanying people to the very end, using the perspectives of the patients, the family members, as well as myself, those bucket full of tears, they’d, helped me reflected out that humbleness.
All of life’s choices are not as simple as “let go” or “not”. I’d started out as a doctor, who’d not wanted to talk about the subjects of letting go with the patients, to now, I’m still that same doctor, who’d felt awful, as I saw my patients in pain, but I believed, that going through the losses alongside the family members, is WAY more precious than the finalities of life itself. That period of considerations on whether or not to let go, it’d, reflected how life had such a strong impact on us all.
Our Hearts, Entangled
The mother who’s grieving, it’s called “love”.
There was a meeting in the respiratory ICU. Guo-Feng, at the age of thirty, fell into a coman due to his subdural hematoma, we’d, attempted to train him to breathe on his own three times, and, failed, and, his mother and older sister asked us to take him off life support.
And, looking at the man, at the prime of his life, without noting how he was, intubated, or that his eyes were, completely, shut, nobody knows, that he’s, a “terminally ill” patient.
The hospice care team, held a family conference with his mother and older sister. Our hearts, started entangling, with the stories of what had happened to their family unfolded.
illustration from the papers online
The mother, with the several spinal deterioration and kidney functions, faced that pain from the nerves day in, and night out, and, how she will have to decide on whether to go on dialysis at any moment in life, lived, inside a small iron-roof shack, and earned the measly incomes from picking up and selling the recycled materials.
Some twenty odd years back, Guo-Feng’s mother divorced his father who had a bad gambling habit, his father run away to hide from the debtors, lost contact with his family, and, left behind, this HUGE debt, for Guo-Feng and his mother to pay up.
His older sister worked as a nanny, whenever she had the spare time and extra money, she’d, given it all to the caring of her own mother and younger brother. In the conversatiosn, although she’d not mentioned her husband, but, I can feel, that she was, very grateful toward her husband, who was, more than tolerant of her family conditions.
Guo-Feng worked as a construction worker. Before he worked his shift at the construction sights, he’d taken another job at a privately owned slaughterhouse to make the extra money, but, the bad luck, it’d, still came towards him, despite how hard, he’d, tried to, dodge it.
On a morning when he was headed over to the slaughterhouse to work, a truck hit him. And, afterwards, the driver was very awful, only visited him once at the hospital, and afterwards, he’d, let the insurance companies deal with the family, and the owner of the slaughterhouse where Guo-Feng worked, he’d, NEVER shown his face, eve then, Guo-Feng’s older sister learned, that the owner of the slaughterhouse, never insured his workers.
And, in the midst of all of these storm, his personal insurance, because his father’s debts from gambling were yet to be paid off in full, all the money that’s wired in to the account, automatically, goes to pay for that, there’s, NO way he could’ve, gotten any money from his own workers’ insurance.
“I’m sorry, my younger brother was so young, at first, we were, very upset, feeling that he will, leave us. But, if he’d, stayted, his days will get even harder, compared to if he’d, died, we couldn’t afford the nursing homes for him, and, following, he will have the bedsores, the limbs will start cramping and withering away, there would be a hole on his neck, he would have to, rely on the respirators to live out the rest of his life, and my mother, she couldn’t, withstand any more of the hardships in this life again.”
My heart turned over and over. They’re, certainly not the ones who should be, apologizing—this extremely difficult decision they’d had to make, they’d still had to fear, how the outside world, the medical experts would, see them, as cold-blooded.
My Mother with Hair All White, Started Crying Hard
There were, a total of three family meetings, and the mother with her hair all white showed up every time, and every time, she’d, cried.
In the end, it was the doctors of the hospice program, the neurosurgeons, the physicians at the respiratory I.C.U., who’d, declared, that Guo-Feng had suffered severe brain damage, that even after a few months, there’s, NO chance he will ever be off of the respirators, and there’s, no chance he will come out of the comatose. And so, he was, sent into the hospice. In the single bed rooms, he was, accompanied, by only a handful of his, loved ones, and I, took him off the respirators, and turned the machines off.
Guo-Feng didn’t leave as we’d expected him to, after he was unplugged; I’m sure, he wasn’t, willing, to leave his own mother behind.
He’d gone into a nursing home afterwards. His strong life force fought on, for over a year’s time, he was, accompanied by the staff of the home, or his older sister, back to my clinic.
Although, she’d, shouldered the burdens of the long-term care, every time his sister came back with him, she always spoke of how grateful she was toward the team of caretakers, the neurosurgical team, along with the respiratory ICU staff, for accompanying them, how they’d, helped the family weather through the possibilities of death, and then, coming back to life again, tears ran dry, as they’d, calculated out all possibilities. And now, the heavens chose to allow Guo-Feng to stay, the family had NO regret over ANY of the decisions they were, forced to make.
Every time, I’d, squeezed his hand, talked to him. I hope, that the memories from his first day of hospitalization, can help him erase that final moment of lucidity he had before his car crash: the surprise, the pains, the fears, as well as this loneliness he now faces, without an exit sigh.
Freud wrote in a letter, “we will, find a place, to put that scent of loss down, we know the griefs of our losses, will eventually, go away, but, we also know, that there’s, no finding console for this feeling, and it’s, incomparable. No matter how we tried to fill up the crack, and, even if we were, able to, fill it up completely again, things, can never go back to the way they once were.” As sorrows entered into our lives, then, we should, accept it, like we accept all our scars, and, keep on, carrying forward, instead of trying to, get it, out of our lives by force, causing ourselves to, bleed repeatedly, there’s, also need to set a time when healing becomes complete either, just trust, that one day, you will, finally find that brand new sunrise through the griefs you’d been, experiencing.
I Just Don’t Want Him to Feel Another Moment of Pain
Two years later, I’d, received a text, asking for my presence to meet up with the families again. It’d been, six whole months since I’d had any news of Guo-Feng, six years ago, because he was, stabilized, so, he was, turned over to the care team of the nursing home, but, in the sessions I’d gone to, his name came up time and time again.
He, who’d always been, assigned to the beds paid for by the national health insurance plans, lay there, quietly, but clearly, he’d, lost some weight, it’d, shocked me a bit.
His mother’s slightly hunched over body, was seen, in the bed of other patients, she was, interacting with all the other families, as she saw me when she’d turned her head, she’d, greeted me, and, told the other family members of how we became acquainted in the respiratory ICU.
Afterwards, we both, got close to Guo-Feng’s bed, I’d, squeezed his hand, lifted my head toward his mother, “his losing weight suddenly, may be his body is facing a bigger problem, and, his now, affected by sepsis, it’s not a high chance, that he will, get through it this time, unless, you put him through a thorough exams and treatment, checking especially the causes of his losing so much weight. But, what can, Guo-Feng get out of all of this? Mom, how do you want to accompany by Guo-Feng’s side, two years after we’d initially met up?”
Guo-Feng’s mother looked upon her son with pity, and, with more of a blessing than grief, she’d told me, “from the day we took him off life-support, I just wanted him to not be in pain, whether it he leaves me today, or two years from now, I will, NEVER forget how hard he’d, fought with me, along with how we’d, decided to embrace everything after we’d, fought very hard. Dr. Hsieh, we want to be transferred into the hospice now, we know, that Guo-Feng would like it there too.”
Two weeks later, with all the blessings, Guo-Feng had, finished up his life completely.
And, this time, no tears fell, only that scent of, gratitude, the roads that Guo-Feng had led us all down: after making that difficult decision, of letting go, stopping the struggles, that scent of new lease on life the families felt as they’d reached a decision, along with that sweet burden of taking care of the terminally ill patient, to the moment when end finally, came, there’s that ease from feeling NO regrets and sorrows and sadness.
Allow us, to talk of “letting go” in an even, milder manner, don’t treat it as the ultimate goal of these meetings, even if it’s a sort of a kindness, making the families who aren’t ready, to sign that DNR, the grief wouldn’t, go away, because of the kindness of letting go.
This hard road, even if we all know where it’d led, we’d still needed to, bend down physically, to remove all the brambles along the way, and even, as our hands got, pricked, the blood will flow from our hands, but, we will, gain that extra courage, from how we’d, conquered the difficult parts of our lives.
“Letting go is mercy.”, this, is very true, to those who are about to lose their loved ones, it’s still, a most cruel sort of rationalism. Allow us, to let grief settle in a bit longer then, as we accompany those patients to the very end, we’d, found love, breached across the sorrows, the anger, the denials, the anxiousness, the loneliness, the fatigue, the helplessness, the numbness too, we will find, that “letting go”, is what comes, naturally to life.
Letting go is not an end, it’s, accepting the sorrows, the losses, and, putting them to rest, it’s also, how life, continues on.
And so, this, is the process of letting go, this woman accompanied the families, as they were, forced to make the most difficult choice in their lives, for the sakes of their loved ones, and, it all worlds down to, how would you prefer to live, in pain, being hooked up to the machines, or, would you, rather, just die, without being, resuscitated?
Life, the Obstacle Course 