That Good Night by Sunita Puri

Author:Sunita Puri
Language: eng
Format: epub, pdf
Publisher: Penguin Publishing Group
Published: 2019-03-05T05:00:00+00:00

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I would run into Dr. Nguyen about a month after Jack left the hospital, when I had moved on to another rotation. We attended a lecture at the Stanford campus and caught up afterward. She would tell me that she had learned that Jack had died recently in the emergency room. He had contracted another infection shortly after returning to the nursing home. His temperature rose and his blood pressure plummeted. The nursing home staff called the paramedics, who’d reassured Mary and Steven that Jack would get better once he got antibiotics and fluids at the hospital. But as they lifted Jack onto a gurney, his heart, initially racing at a rate of 120, suddenly slowed to the 30s. Jack’s heart stopped, and Mary and Steven asked the paramedics to do whatever they needed to do to save their son. One of the emergency room notes mentioned that Mary had torn up the POLST we’d filled out and signed together.

The team of doctors and nurses in the emergency room tried for an hour to restart his heart with chest compressions, shocks, and doses of epinephrine pushed through his IV. He died there in that room, several floors below the ward where Dr. Nguyen and I had discussed how little benefit and how much suffering CPR would cause him.

I imagined Jack’s wrinkle-free face, his braid, his pillow and quilt, covered with the necessary clutter of emergency situations: IVs and their sterile wrapping, smatters of blood from the placement of central lines or collection of labs, wires dangling from cardiac monitors and the ventilator. I winced as I thought of what he went through, of what must have caused his mother to tear up the form meant to protect him from exactly this situation. I wished that he’d died in the middle of the night, in between nursing shifts, so that he could have gone in peace. I hoped for his parents’ sake that they would remember him by how he looked the day or week before he died, not how he looked at the end.

“Why would they put him through that?” I wondered when Dr. Nguyen told me the news. “I really thought we’d helped them to make the right decision.”

“It’s hard to say. People panic. Parents panic,” she told me. “But you should remember that we did help them, even though the outcome wasn’t what we hoped for him. It’s like doing a surgery that didn’t fix a patient. The work was still important.”

I didn’t find comfort in Dr. Nguyen’s words. I couldn’t understand how she was so calm and collected about this. All our work ultimately didn’t do a thing for Jack, I thought angrily. It was as though we hadn’t been involved at all. What had all of those conversations meant if Jack’s parents stuck to their original plan? I longed for the days when I could diagnose cirrhosis or lymphoma, treat pneumonias and heart attacks, even if it meant that this was all I did for thirty hours straight every third or fourth night.

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