Hospice

Today, when I walked into a patients room to talk to him, he said, "Mercy."

I wasn't sure if this 90 year old male with dementia said what he said.

I asked him, "Did you just say mercy?"

He said yes and nodded. It broke my heart. 

It's sad that aggressive treatments have come to this. When families want "Everything done" they don't see what we actually do.

There comes a point in life when it is okay to refuse treatments, not because you're negligient and ignorant about your health, but because it is the right thing to do.

With all our technological advancements in medicine, we can keep a body alive. We can have a ventilator with tracheostomy breathe for the patient, we can feed through a PEG tube, we can replace the kidney with dialysis, we can keep the blood pressure up with pressors. Sometimes, we can even bypass the heart and lungs through extra corporeal membrane oxygenation (ECMO). But just because we can do it, doesn't mean we should do it. What about quality of life? 

Medicine can only do so much. There comes a point in the natural course of human life when the body can't heal anymore. That's when it's okay to say, "No more." It's time for comfort care and hospice. 

Fortunately, for my patient, the physician explained about end of life to the decision makers and the family understood the goals of care. The patient was discharged to hospice.