Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Death is a blessing in its right time and place

Uzma Khan, MD
Physician
March 24, 2017
460 Shares
Share
Tweet
Share

I am working hospitalist right now. On Friday, a man in his 80s was admitted with difficulty breathing. He had a complicated history, including a heart attack at age 35 with all the subsequent sequela of heart disease. He had an abnormal heart rhythm and was taking a blood thinner for stroke prevention. In addition, he had scarring of his lungs (cause unknown).

He was transferred to us from another hospital. He had shown up at the other hospital with a nosebleed (side effect of the blood thinner). In an attempt to stop the nosebleed, he was given blood and plasma transfusions. Nasal packing was placed. He subsequently ended up having a hard time breathing, and a breathing tube was placed. He managed to eventually come off the ventilator and was transferred to us.

I went into his room to introduce myself. His skin was wrinkled, and his hair was white. His nasal packing was still in place. His face was covered with an oxygen mask. I could immediately see that he had twinkly and jovial eyes. I reviewed his history with him and asked him how he was feeling. He said he was doing a little bit better, but said he has been having a hard time breathing for years. He wanted to know where I grew up and where I went to school. He told me that he was from New Jersey. We shared some exchanges about East vs. West Coasts. He told me about his children (one is a physician).

About 45 minutes after I left his room, his nurse called me.

“He can’t breathe.”

I asked her to get a BiPAP machine at the bedside. (A BiPAP machine blows pressurized air through the mouth to help with breathing.) I returned to his room and met his son-in-law at the bedside. My patient looked at me, his eyes pleading. I sat at his bedside. I explained what the BiPAP machine was and how I hoped it would help him. I told him my job is to hope for the best but to prepare for the worst. I explained to him that while I was optimistic that the BiPAP would work, there was a chance it might not work and the next level of care would be to insert the breathing tube again.

Nasal packing in place and oxygen mask over his face, he started shaking his head. He told me he never wanted to go through the breathing tube again. I asked him if he understood what would happen if his condition deteriorated and we didn’t place a breathing tube. He gave me a thumbs up sign and said he completely understood.

“Doc, I’ve been suffering for a long time. I haven’t been able to breathe well for years. I had to move out of my house last year. My wife died three years ago. I’m ready.”

I assured him I am his advocate and my goal was to respect his wishes.

His son-in-law affirmed everything my patient was saying. He connected me via phone to my patient’s daughter and (physician) son. They both said that they didn’t agree but they respected their father’s decision for himself. With the family’s permission, I called our palliative care team to meet with us and review what it means to “be comfortable” and “die with dignity.”

My patient remained clear and lucid. He asked me to withdraw care that would prolong his life. With tear-brimmed eyes, he told me he was tired, and he was ready. In jest, he asked me for a scotch. He thanked me profusely. Unfortunately, I was not going to be his doctor over the weekend. I told him I would be thinking of him and that I would be happy to see him Monday if he were still in the hospital. He lifted my hand to his oxygen mask and “kissed” it. He thanked me again and again. I said my goodbyes to him, his daughter (who had arrived by then) and his son-in-law. Just as I was about to leave, he wanted to know what part of Arizona I’m from. I told him, and he thanked me again.

Per his request, I stopped all life-sustaining medications and ordered morphine. I thought of this man all weekend long. How lucky he was to be so mentally sharp at his age. How lucky he was to articulate what he wanted. How lucky he was to have such a nice family who respected his decision.

The loss of life, even if anticipated, still makes me sad despite all my years of being a physician. I went to work at 8 a.m. today. I learned that he passed away peacefully and comfortably at 4:15 this morning. Feels bittersweet, but there is solace in knowing that he is no longer suffering. When my last living grandparent turned 90, he told us that “God has blessed me with everything except death.”

Even death is a blessing in its right time and place.

Uzma Khan is a hospitalist and can be reached on Facebook.

Image credit: Shutterstock.com

Prev

Life expectancy has lengthened, but not equitably

March 23, 2017 Kevin 0
…
Next

A hospital, a stranger, and a bottle of beer

March 24, 2017 Kevin 0
…

Tagged as: Hospital-Based Medicine, Hospitalist, Palliative Care

Post navigation

< Previous Post
Life expectancy has lengthened, but not equitably
Next Post >
A hospital, a stranger, and a bottle of beer

More by Uzma Khan, MD

  • The immense kindness and humanity surfacing from the pandemic

    Uzma Khan, MD
  • A few weeks into COVID-19: Alternating between sadness, fear, optimism, and anger

    Uzma Khan, MD
  • An emotional day as a doctor

    Uzma Khan, MD

Related Posts

  • How death is a blessing and a burden

    Fatema Shipchandler
  • Doctors: It’s time to unionize

    Thomas D. Guastavino, MD
  • Finding happiness in the time of COVID

    Anonymous
  • I never expected death to be so blunt

    Natasha Mathur
  • It’s time to end the USMLE Step 3 exam

    Madeline Wozniak
  • A medical student’s reflection on time, the scarcest resource

    Natasha Abadilla

More in Physician

  • From journalism to medicine: Unveiling the untold stories of patients’ medical conditions

    Veronica Bonales, MD
  • A mentor’s legacy in medicine, leadership, and embracing evidence-based care

    Arthur Lazarus, MD, MBA
  • Breaking free from restrictive covenants to combat burnout

    Raya E. Kheirbek, MD
  • From medical student to intern: Discovering a deeper connection with patients

    Johnathan Yao, MD, MPH
  • A physician’s typical day, as envisioned by a non-clinician health care MBA: a satire

    Jennifer Lycette, MD
  • Decoding name displays in health care: Privacy, identification, and compliance unveiled

    Deepak Gupta, MD
  • Most Popular

  • Past Week

    • We need a new Hippocratic Oath that puts patient autonomy first

      Jeffrey A. Singer, MD | Physician
    • Is chaos in health care leading us towards socialized medicine? How physician burnout is a catalyst.

      Howard Smith, MD | Physician
    • Boxing legends Tyson and Foreman: powerful lessons for a resilient and evolving health care future

      Harvey Castro, MD, MBA | Physician
    • A physician’s typical day, as envisioned by a non-clinician health care MBA: a satire

      Jennifer Lycette, MD | Physician
    • Decoding name displays in health care: Privacy, identification, and compliance unveiled

      Deepak Gupta, MD | Physician
    • From Moscow Mule to the opioid crisis: Unveiling the tragic legacy and urgent solutions

      Osmund Agbo, MD | Meds
  • Past 6 Months

    • It’s time to replace the 0 to 10 pain intensity scale with a better measure

      Mark Sullivan, MD and Jane Ballantyne, MD | Conditions
    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • Unveiling the hidden damage: the secretive world of medical boards

      Alan Lindemann, MD | Physician
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
    • An inspiring tribute to an exceptional radiologist who made a lasting impact

      Kim Downey, PT | Conditions
  • Recent Posts

    • From Moscow Mule to the opioid crisis: Unveiling the tragic legacy and urgent solutions

      Osmund Agbo, MD | Meds
    • From journalism to medicine: Unveiling the untold stories of patients’ medical conditions

      Veronica Bonales, MD | Physician
    • Unlocking resilience: a powerful journey from trauma to transformation [PODCAST]

      The Podcast by KevinMD | Podcast
    • Overcoming the lies of depression: Senator John Fetterman’s struggle with mental health

      Harvey Max Chochinov, MD, PhD | Conditions
    • Master the ABIM Certification exam with effective strategies: insider tips for success

      Farzana Hoque, MD | Education
    • A mentor’s legacy in medicine, leadership, and embracing evidence-based care

      Arthur Lazarus, MD, MBA | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 2 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • How I Became a Physician on Food Stamps
  • Chicago PD Measles Outbreak; Affordable Care Hearing Starts; New Apple Health Apps
  • New Data in NSCLC Bolster Support for Perioperative Immunotherapy
  • Breathing Support Type Matters for Preventing Extubation Failure in the PICU
  • Second-Line Axi-Cel Bests Standard in Relapsed/Refractory Large B-Cell Lymphoma

Meeting Coverage

  • New Data in NSCLC Bolster Support for Perioperative Immunotherapy
  • Second-Line Axi-Cel Bests Standard in Relapsed/Refractory Large B-Cell Lymphoma
  • New Agents for Relapsed/Refractory Myeloma Impress in Early-Stage Clinical Trials
  • CAR-T Tops Standard Care in Heavily Pretreated Lenalidomide-Refractory Myeloma
  • T-DXd Proves Mettle in Multiple Solid Tumors
  • Most Popular

  • Past Week

    • We need a new Hippocratic Oath that puts patient autonomy first

      Jeffrey A. Singer, MD | Physician
    • Is chaos in health care leading us towards socialized medicine? How physician burnout is a catalyst.

      Howard Smith, MD | Physician
    • Boxing legends Tyson and Foreman: powerful lessons for a resilient and evolving health care future

      Harvey Castro, MD, MBA | Physician
    • A physician’s typical day, as envisioned by a non-clinician health care MBA: a satire

      Jennifer Lycette, MD | Physician
    • Decoding name displays in health care: Privacy, identification, and compliance unveiled

      Deepak Gupta, MD | Physician
    • From Moscow Mule to the opioid crisis: Unveiling the tragic legacy and urgent solutions

      Osmund Agbo, MD | Meds
  • Past 6 Months

    • It’s time to replace the 0 to 10 pain intensity scale with a better measure

      Mark Sullivan, MD and Jane Ballantyne, MD | Conditions
    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • Unveiling the hidden damage: the secretive world of medical boards

      Alan Lindemann, MD | Physician
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
    • An inspiring tribute to an exceptional radiologist who made a lasting impact

      Kim Downey, PT | Conditions
  • Recent Posts

    • From Moscow Mule to the opioid crisis: Unveiling the tragic legacy and urgent solutions

      Osmund Agbo, MD | Meds
    • From journalism to medicine: Unveiling the untold stories of patients’ medical conditions

      Veronica Bonales, MD | Physician
    • Unlocking resilience: a powerful journey from trauma to transformation [PODCAST]

      The Podcast by KevinMD | Podcast
    • Overcoming the lies of depression: Senator John Fetterman’s struggle with mental health

      Harvey Max Chochinov, MD, PhD | Conditions
    • Master the ABIM Certification exam with effective strategies: insider tips for success

      Farzana Hoque, MD | Education
    • A mentor’s legacy in medicine, leadership, and embracing evidence-based care

      Arthur Lazarus, MD, MBA | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Death is a blessing in its right time and place
2 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...