Yes, on the frontline we make DNAR decisions. Do we ventilate you? Resuscitate you if you die? Take over that tiring business of breathing?
Is this difficult? Actually it isn’t, not often. The problem is that if the lungs are down, other organs are in trouble. If it’s just ventilation it’s not so hard.
Please don’t be worried, we are on your side. We want you to live. But sometimes reality and decisions need to be faced. There are easy conversations; but discussing resus decisions with families does not come into that category. Would your grandmother have wanted to stay alive on life-support? There is no such thing as a life-support machine, but if there was, it would be a ventilator on intensive care surrounded by loads of other pumps and drips.
A spell on ICU is like being hit by a bus. No one comes off as they came in. Weeks and months to recover.
Back to the DNARs. The forms. There are advanced directives. Filling in your wishes in advance: I want this — I don’t want that. My dad has one. He’s almost 90. “No heroics please. I will check out when I’m done.” My mum? Lie about your age says I — pretend you’re 10 years younger. Because none of us is immune to age bias.
If you are in there with a chance I am right behind you. We just know what dying looks like. To be honest, it’s probably the only useful skill that doctors had until we found penicillin. So in this Covid-19 world, I promise you that even if lives were lost earlier than nature or fate or God intended, it was not to ration the kit or defend limited resources. I’m on your side.
