Reaching for the Light
The matriarch of the family had reportedly lived a rich and fulfilling life, but the last few months had been hard on her. Since suffering a surgical complication and a rough postoperative course, she had lived in the hospital more often than not. So when she was found unresponsive in bed only a few days after her latest hospital discharge, it looked like the end was near.
Unfortunately, but not surprisingly, her doctors had not discussed end-of-life issues or overall prognosis with the family, and she did not have an advanced directive. So the difficult conversation was once again left to me. Perhaps it was the massive stroke it appeared she had suffered, the deep coma she remained in, or the cumulative strain of the last few admissions. Perhaps it was simply her age, which was certainly advanced. Or maybe it was something else. But for whatever reason, this was one of the easier "let her go" discussions that I have encountered. The family was unanimously comfortable with the idea that maybe she shouldn't be intubated or placed on life support.
We then stepped outside the patient's room so that a chest X-ray could be taken, and I swear to God this is true. As the radiology tech aimed his targeting light on her chest to center the beam on the X-ray plate, this woman who hadn't moved a finger despite our yelling her name, inserting an IV, or giving her a sternal rub... gradually raised her hand up towards the light.
That was freaky.