Portal de Periódicos da CAPES

The Best Medicine at the End of Life

2015; Volume: 11; Issue: 2 Linguagem: Inglês

10.14797/mdcj-11-2-151

1947-6094

Ryan Gravolet,

Ethics in medical practice

I will never forget her eyes, sunken and dimly lit with the dying embers of hope.She was scared, exhausted, and wildly scanning the room filled with doctors, nurses, and hospice workers, looking for reassurance and any good news we could provide about her husband.Looking for a friend to say this was all a big misunderstanding.The young woman sat and waited for the emergency medical meeting to begin, desperate to know the prognosis.Just 3 days prior, her perfectly healthy 39-year-old husband suffered a massive heart attack and was rushed to Houston Methodist Hospital in an unconscious state, precariously positioned on a thin ledge between life and death.After multiple operations, he landed in Bed 1 of the Cardiovascular Intensive Care Unit with all eyes on him.The medical team included cardiothoracic surgeons, cardiologists, pulmonologists, intensivists, and nephrologists who did everything possible to preserve life: two mechanical heart pumps, maximum doses of intravenous pressors, full ventilatory support, and continuous dialysis.But the patient was not getting better and remained in severe heart failure.Heightening the challenge of an end-of-life discussion, the young woman spoke little English.She and her husband emigrated only months earlier from Vietnam, and they had been in the midst of their happiest days.A new baby due in 8 weeks.A new business.At a time when the photo albums would be overflowing with life's milestones, the young woman sat around a circle of strangers pleading for good news through a translator.After introductions were made, the young woman's attention focused on the attending physician, and the meeting began.The attending spoke, "Thank you for meeting with our team today.As you know, your husband had a large heart attack, and we are doing everything we can to keep him alive.Unfortunately, his heart is failing and not showing signs of returning function."We watched her as the translation was received.She leaned forward expectantly, not fully certain of the news, and her expression pleaded for more information.Her voice trembled as she struggled to say, "But he can recover…."