How Will You Spend Your Last Birthday?

   There was a patient in the ICU, who was brain dead, with no chance of meaningful recovery.  I didn't know her that well, but just listened when we rounded on her as a team.  The residents were getting annoyed because the family was dragging their feet on withdrawing care.  Not that they were obligated to withdraw care, but they had decided they were going to withdraw care, but kept prolonging the date they were gonna do it.

   Our attending remarked, "You know, as young physicians, I understand it is very hard not to be judgmental of patients and their families. But please, you must try to understand what they are going through.  This woman is somebody's wife, somebody's sister, somebody's daughter.  And this is the last moment in her life.  Just think about that.  Think about what it'd be like to be in their shoes.  The husband hasn't been sleeping for weeks.  He's a wreck, and he is understandably having a hard time dealing with this, so let's give him a little compassion."

  And as the attending gave his speech, the nurse walked in and began hanging pieces of paper around the room.  As I looked closer, I realized she was hanging signs with a picture of a birthday cake saying "Happy Birthday".  I almost lost it.  Here this woman was, laying in a coma, surrounded by doctors and med students she never met, with tubes and wires coming out of every inch of her body, while her family was at home agonizing about letting her go, on what will be her very last birthday.