Ten years ago, I cared for an elderly man dying of heart failure in the emergency department. He refused life support and received comfort care. Still, the nurse and his wife took turns yelling, “Breathe . . . breathe . . .  breathe!” The disrespect shown to this gentleman taking his last breath prompted me to “say something” through blog posts, speaking … [Read more...]

Lee, aged 75, had all the trappings of chronic illness: hypertension, diabetes, high cholesterol, heart disease and had a previous stroke. She wore a prominent “DNR” wristband. Staff at her care facility called EMS when she experienced flash pulmonary edema and was struggling to breathe. Lee arrived in the emergency department with a verbal directive that … [Read more...]

Shortly after Rosie arrived in the emergency department, she was ready to return home. At age 89, she appeared to be a well-put-together woman and was aware of her surroundings and medical conditions. Before arriving in the ED, Rosie was experiencing difficulty breathing and alerted her daughter, Tara. With her mother having congestive heart failure and … [Read more...]

Wayne, aged 67, didn’t have a choice when his wife decided to not prolong her life after breast cancer was diagnosed 10 years ago. Wayne was now faced with a similar choice for himself. His cardiologist instructed him to go the emergency department to have fluid drained from his lung cavity that resulted from recent pneumonia that led to sepsis. The … [Read more...]

The recent testimony of Dr. Christine Blasey Ford to the Senate Judiciary Committee reminded me of what every other patient experiences in the emergency department. The other half of the population appeared like Brett Kavanaugh. Dr. Ford alleged that Mr. Kavanaugh was intoxicated and sexually assaulted her while they were in high school. She grew up to be a … [Read more...]

Jerry and his wife, Pam, were not “medical people” and wouldn’t be considered high achievers. They seemed to be taking life in stride with a “mom and pop” disposition.  Jerry had Alzheimer’s disease and was returned to his care facility after having a pacemaker inserted. The staff noticed Jerry slumped in his chair and called 911. Jerry’s blood pressure was … [Read more...]

Imagine being John McCain and told you have an incurable brain tumor. What thoughts run through your mind? What’s your main priority? How would you want others to treat you? “I don’t know” is the most likely answer. Without question, John McCain served his family and country with distinction and deserved to be treated with dignity. But what did … [Read more...]

Medicare is a federal insurance program that covers certain health care costs for qualified Americans, generally those age 65 and older or those with disabilities. According to survey data from the National Retirement Institute, approximately 90 percent of … [Read more...]

“What you want – Baby, I got it” were the lyrics that showcased Aretha Franklin’s famed life and virtuous death. Like a song that becomes an anthem, her life had a resounding impact on others. “We’re goin' ridin' on the freeway of love,” was Aretha’s invitation to this gay, white boy to join her in solidarity. Her use of the universal language of love fueled … [Read more...]

At 90, Ben appeared to be complacent with age and content having others tell him what to do. Every morning Ben experienced transient vertigo while getting out of bed. He happened to tell his visiting nurse about it and she detected an irregularity to his heartbeat and elevated blood pressure. She recommended Ben go to the emergency department. Ben’s … [Read more...]

“I remember you,” said Gracie with the look of having found a long-lost friend. “You gave my husband the option to be treated aggressively in the hospital or return home with palliative care.  He chose to go home.” I hesitated to ask, “How did he do?” Gracie went on to say that her husband had passed in the last month, yet lived nine months following our … [Read more...]

Josh was carrying his 78-year-old mother, Amelia, from her wheelchair to a stretcher when the emergency physician walked in.  Seven years ago, Amelia had a stroke that paralyzed her right side. Her husband had been her primary caregiver until he died of a heart attack four days ago. Amelia was trying to do for herself despite Josh’s best intention to keep … [Read more...]