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[pnwmom]

5. I wonder if this will change your mind:

http://opinionator.blogs.nytimes.com/2015/02/07/when-doing-everything-is-way-too-much/?hp&action=click&pgtype=Homepage&module=c-column-top-span-region®ion=c-column-top-span-region&WT.nav=c-column-top-span-region

By the time I met him, Vincent was no longer really with us. The only signs of life occurred during dressing changes and bed-turning, when, despite extra pain medication, pain fired up dormant neurons and his blue eyes flared. There was no family, no friend, no person from Vincent’s life to serve as a guide for our treatment goals. There was only his advance medical directive, which he had completed 10 years and a lifetime earlier at the age of 75. And a handwritten note stapled twice to the form.

SNIP

The measures taken to minimize the spread of these dangerous bacteria further isolated him from the world of the living. He would never again feel the touch of human skin on his body, just the leathery latex of a disposable glove, the brush of a papery gown.

SNIP

On that ninth admission, when I took over his care, I was almost unable to complete my physical exam. This man’s body was being eaten away to a degree I had never seen. Autodigested while dying. Even with the most attentive nursing care, a flaccid, dying body has pressure points where thin skin eventually breaks down. In bad cases, the tissue breakdown extends into muscle, and in the worst cases, it goes down to the bone. Vincent’s shoulder and heel ulcers were severe. But the one that stopped me in my tracks started at the low end of his spine and spread toward his left hip, melting skin and muscle away so that his entire hip socket lay open to the air. Even as a seasoned I.C.U. physician, I gasped the first time I laid eyes on it.

I am sure that Vincent could not have known what he was setting himself up for when he wrote that note. He could never have imagined that with our fancy treatments, we could keep his body going even while it was trying its hardest to die. And now he was suffering, with every terrible dressing change, every lonely hour in an I.C.U. isolation room, and all of his grit drained from his body.