Perhaps most troubling to me of Hope or Letting Go, was Dr. Youn's question about whether the patient and his wife should be given a chance to say good-bye.
Good-bye's are a powerful element of loving relationships. We say good-bye before a loved one leaves for a trip, whether the destination is thousands of miles away or the corner grocery store.
In Final Good-byes, I discuss the importance of clinicians saying good-bye to patients at their last office visit before entering hospice or other end-of-life setting.
Hollywood dramatizes the final good-bye before a tragic death (think, Rose and Jack saying good-bye as his hand slips out of hers and he sinks in the frigid ocean). But in real life, rarely do patients and loved ones know which moment is the one before it's too late to say good-bye.
Let's narrow the topic down to situations where a healthy person suffers a mortal wound, such as when Jerry was wheeled in with burns over 90% of his body and needed to be intubated.
- If the doctors encourage the patient and his wife to say good-bye, won't that make them both hopeless for recovery? And don't clinicians have an obligation not to extinguish patients' hope?
- If there is even a tiny possiblity of recovery, shouldn't the healthcare team nurture Jerry's (and his family's) hope that he will be the one who recovers? Shouldn't the doctors nurture their own hope for this patient?
My next post will address these questions in the context of saying good-bye.