I have been blessed and cursed with a mother who has just enough medical knowledge to be dangerous. Once an occupational therapist, she knows the ins and outs of the human body, and she’s not afraid to share it.
Sometimes, I become impatient with this imparting of medical expertise…. like I want to protect the doctor from this crazy woman spewing high level terminology like “cardio,” “thrombo,” and “pleuro.” But, on better days (my own), I can sit and watch Mom regale the doctor with her credible medical references, and summon up a little awe at her great memory and intelligence.
Lucky for me, Mom also looks forward to a little poking, prodding, and pricking. Doctor’s appointments have become the highlight of her week. Fresh air, one-on-one attention and social interaction with like-minded people; I get it.
Our office visit begins with three simple questions – 1) Can you please complete this form (for the billionth time?) 2) Any changes in your health (since last week?) 3) Do you have your insurance card? (Yes, the same every single time.)
Mom and I take our seats in the exam room. The doctor enters, greets Mom like a lifelong pal, and reviews her electronic medical chart. She comes to an abrupt halt, noting, somewhat accusingly, that Mom’s file is missing her Health Care Proxy and a DNR (Do Not Resuscitate.)
The doctor asks me to bring these documents as soon as possible, adding, “we also like patients to complete this new form for a better understanding of exactly what level of resuscitation they do, or do not, want.”
After our appointment, Mom and I head to IHOP for our usual post-doctor repast. With our food order in, I retrieve the detailed DNR form from my purse. WHOAA…this has a billion seemingly very similar questions.
In theory, the DNR sounds pretty simple; if Mom’s heart stops, does she want CPR, or, if she stops breathing, does she want a tube down her throat? Yes, and Yes, I say.
But the questions on the new and improved DNR have highlighted our ignorance with regard to life-sustaining options for Mom. Apparently, there are degrees, or levels, of resuscitation…. just how much do we want to keep Mom alive? Or, just how much alive, does Mom want to stay?
With the expanded form, Mom has endless possibilities for continued life—or not—including Intubation/Ventilation; Non-Invasive Ventilation; Dialysis; Artificial Nutrition; and Artificial Hydration.
For each of these lifesaving options, Mom has to choose one of the following: None; Short Term Only; Undecided, or my personal favorite, Did Not Discuss.
Waiting for our food, we delve into what should be a serious conversation, but we just can’t seem to be serious.
“So…. Mom… what do you think “short term” means?”
“Hmmm… I don’t know… When you’re 91, there’s really no long-term to even consider,” she says.
“Good point,” I laugh. “Is there really time to be ‘undecided’ if you’re in need of a lifesaving measure?” I laugh again.
“Maybe I could give you a signal, move my feet left for ‘yes’ and right for ‘no’, or give you a thumbs up, or thumbs down,” she says.
“If you pick ‘short term only’ do we let you go for another minute, or another month?” I say smiling. We are both crazy at this point.
“I don’t know, but we better figure that one out. I’d hate to think you’d come up short by one minute, and I could have gained another five years!” she jokes back at me.
Clearly, the subject of extending or prolonging an individual’s life is no laughing matter, and I’m sure these additional DNR questions have arisen from multiple lawsuits filed against members of the medical profession. With all the possible combinations of death and resuscitation to consider, I think SNL could have a field day with a DNR. My mother is definitely in on the joke.
We buckle down, take a more serious approach to the form, and eat our pancakes.
Turns out, Mom is in no rush to leave this world. She actually wants a semi DNR. Yes she’d like artificial food and water to stay alive; Yes she would like some air forced into her lungs if she can’t breathe (at least for a little while); Yes she’d prefer it noninvasive, if possible.
The only lifesaving measure Mom stalls on is dialysis; t’s something she’s never needed, or even considered before. Mom checks the Undecided box, a surprise to both of us. Just minutes before, we thought the idea of being undecided with regard to a lifesaving measure was laugh-worthy. This time? Not so much.