This scene is similar to those found in A Death Prolonged

Dr. Dawson assessed the vital signs, lab values, with particular attention to the hemoglobin level, and examined Mr. Dankowski. Dr. Dawson reviewed the findings and plan of attack, while Kate and the other residents looked on. Then he moved along Mr. Dankowski’s bedside where he could maintain eye contact with both Mr. and Mrs. Dankowski.

He parked himself in a chair, dropped his arms, and leaned back. His tone was conversational as he said, “Mr. Dankowski you’re doing quite well and I expect you to fully recover.”

“That’s good to hear, Doc. I expect a full recovery, too. My roses need tended this weekend,” he said with a grin.

“The issue we need to discuss is your wishes about end-of-life medical care. Has anyone discussed that with you?”

“I can’t remember anyone talking to me about the end of my life, besides my wife. But she’s tired of me after 62 years.” He chuckled and glanced at his frowning wife.

“Mr. Dankowski, I want you to understand our hospital procedures so you can make decisions about what type of medical care you would want.”

“That’s fair enough. Go ahead, Doc.”

“While you’re here at Mercy we automatically do everything to keep you alive. If your heart were to stop, then we would do everything possible to revive you. The reason I bring this up is because most people have never thought about it or discussed it. I want you to understand what we do so you can make a choice in the matter.”

Mr. Dankowski’s grin evaporated and his voice became serious, “I’ve thought about dying: what 82-year-old man in his right mind hasn’t? But no one’s discussed this with us.”

“If you die—if your heart or breathing stops—resuscitation efforts begin with cardiopulmonary resuscitation. That’s done by pressing on the chest and giving respirations by way of a mask or a tube that we insert into the wind pipe. Most every survivor of resuscitation ends up in the Intensive Care Unit on a breathing machine for a period of time.”

Kate watched Mr. Dankowski’s expression harden as he said, “Hold on, Doc. Did you say breathing machine? I don’t want anything to do with a breathing machine.”

“If your breathing stops would you want to be on a breathing machine if it meant prolonging your life?”

“No sir!” he scowled. “Nora and I’ve seen too many folks suffer and die on those blasted breathing machines. If I stop breathing, let me die.”

“Then we need to change your Code status to Do Not Resuscitate.”

“Let’s get it done.” He hesitated and looked at his wife and asked, “Nora, you feel the same way don’t you, honey?”

“Yeah, Ronnie, I don’t want to die, but it would be worse being on one of those awful machines. I wouldn’t want to be resuscitated either.”

Dr. Dawson interrupted, “Mr. and Mrs. Dankowski, I don’t want you to believe that breathing machines are bad: they’re not instruments of torture. They have their place and help save thousands of lives, just like that scope saved your life last night. But it’s clear to me what your wishes are. You would not want to be resuscitated or placed on a breathing machine, right?”

“That’s right,” he said with an emphatic nod.

“We have some paperwork that we’ll complete for both of you. I suggest you get a copy to your doctor and bring this with you when you come to the hospital in the future. You should let your family know your decision, too.”

“Will do. I appreciate you bringing this up. We’ve been thinking about these things, but never got around to talking to anyone.”

“If you have friends that have never discussed these end-of-life decisions with their doctors, encourage them to get it done. We want people to make informed decisions.”

“We’ll see what we can do.”

Dr. Dawson nodded and said, “I bet you will. We’ll see you tomorrow morning, sir.” Then he arose, shook hands with both Dankowskis, and strolled toward the door with his residents in tow.

As they marched toward the elevator, Kate chimed in, “You made that look too easy, Dr. Dawson. I shake every time I think about having that conversation.”

“I’ve had a little more practice than you, but what makes it scary?” His eyes lifted from Kate to the other team members, knowing they all had fears about this conversation.

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