reply to post by Grock
I work a critical care unit, and see more people on life support in a month than most people ever see in their whole lives. The term "life support"
sounds ominous, and complex, like it is portrayed on TV. It usually simply consists of a ventilator to breathe for you, maybe some drugs to keep your
blood pressure from dropping out, and if you're there long enough, some external means of feeding you through a tube.
While it seems mundane to me, I am aware that the techniques are a modern marvel, and wasn't widely available 40-50 years ago, and was not as
effective as it is today just 10 years ago. The problem is that it is a blessing, and a curse at the same time.
Sometimes someone comes in that is really sick or hurt, and just needs to be on the vent. for a day or two, until their body can heal a little, and
pick up again, and they're fine. In this case it is a life saving treatment that gives people a new lease on life.
Sometimes someone comes in that is a total train wreck, either from trauma, disease or old age. They usually stay on the vent for weeks, or even
months. Some get better, some don't. The problem is that the longer you are on the machine the less chance you will ever come off. Your body gets
conditioned to not having to breathe on it's own. After a certain amount of time, even with the most excellent of care you begin to degrade. Muscles
atrophy, skin breaks down, etc... Your body lives by the rule "use it or lose it".
Most people aren't ever emotionally ready to let a loved one go. The decision maker feels overwhelmed by the responsibility of "pulling the plug".
The "one in a million" stories like the one in the OP comes to mind, and they feel justified in waiting another day or week etc... For every OMG he
woke up!!! It's a miracle!! A thousand suffer needlessly while people try to come to grips with their feelings, and wait for a miracle that isn't
coming.
To put it in perspective. I had surgery about a year ago. It was minor, 20 minutes actually, but I was put under general anesthesia, and
intubated(put on a ventilator) for the procedure. Since it was so short, I woke up early with the tube still in, and although I could move a little I
was still VERY weak. I knew perfectly well what was going on, and I even knew some of my caretakers personally, and their voices were relaxed, and
calm. I KNEW everything was fine, yet some primal instinct inside me was screaming, "no, no, NO!! this is wrong! get the tube out NOW! I was
panicking inside. I remained calm on the outside. I was not in pain. the tube was uncomfortable, but didn't hurt. I could breathe fine, but could not
communicate, but the sense of panick was overwhelming, and I knew exactly what was going on, and that it was very mundane, and standard for that type
of operation. Now, imagine waking up in that situation, and NOT know what is going on. Long term vent patients are usually sedated, and restrained for
safety, but that doesn't mean the mind is not active. I have spoken to patients that have recalled horrible nightmares while on a vent., although
most do not remember anything thankfully. Some are on a vent so long that we "surface" them, or turn off the sedation, and let them stay awake while
on the vent. Most cope well with it after awhile, but the day they can come off, and stay off is still like redemption day. Many, many of them express
wishes to never go back on even to save their lives, others wish to only be on a couple of days, and then no more if their is no improvement.
The ventilator is awesome when it can save lives, and it does everyday. It can also become a hellish prison when used to prolong agony. The worst I
have ever seen was a man kept alive for over a year because the family didn't want to lose his pension check. The poor soul literally rotted to
death. There are fates worse than death!