I know we’re not supposed to have favorites, but Lizzy was one of mine…
This brief viewpoint is very thought provoking. I’ve copied the beginning below.
David N. Korones, M.D.
N Engl J Med 2013; 369:1291-1293October 3, 2013DOI: 10.1056/NEJMp1304941C
The article is available at: http://www.nejm.org/doi/full/10.1056/NEJMp1304941
I know we’re not supposed to have favorites, but Lizzy was one of mine. She was 8 years old. Her eyes still sparkled, even though her curly brown hair had long since fallen out because of radiation and chemotherapy for a malignant brain tumor. When the tumor recurred, her parents and I knew she would ultimately die of her disease. But she felt fine, and it was impossible not to give second-line therapy a try. Things did not go well. Within 2 months, Lizzy had a worn and vacant stare, and her normally animated face was expressionless.
Then, during an MRI, she inexplicably went into respiratory distress and was whisked away to the emergency department. I saw her in the trauma bay, laboring to breathe, her eyes ablaze with fear and confusion. She would die if she wasn’t intubated. But should she be? We went back and forth: she would ultimately die of her disease, and perhaps that was happening now. But it was so sudden, and what if the problem was something fixable — a pulmonary embolus or aspiration pneumonia? On the other hand, how much more should a dying child have to endure? Yet those of us who loved Lizzy were ill prepared to let her go.
To escape the chaos of the emergency department, I sat with Lizzy’s parents squeezed into a storage room crowded with monitors and IV poles. We discussed the pros and cons of intubation, and through tears her mother asked me, “What would you do if it were your kid?” ………..