Someone lost their husband tonight.

Middle-aged guy. He was in with pulmonary embolism and I think a terminal illness. He was on multiple vasopressors, but was still declining. He had a great will to live 'til this coming weekend because of a big family event. It wasn't meant to be.

I'm sure most people think of their deaths every once in awhile. I'm almost positive no one that is currently healthy expects to die with a conforming mask over their mouth with air being squeezed in, surrounded not by loved ones but by harried healthcare workers running to and fro, trying to arrange an emergency intubation.

That, of course, is how this man died tonight.

His wife and family wanted him to remain a "full code" up until this point. I don't know why - maybe because they really didn't think he would die, maybe because they wanted him to last until the weekend. He was not my patient, so I don't know any specifics about his case.

He declined very quickly, and I started bagging him (the mask over the face kind of bagging) while his nurse called for the ER doc to come over and emergently intubate him. A visitor that was in the room looked at the patient and said, "Well, bye now," as though the patient was just going to wake up and reply, "See ya later." I found that to be a very odd way to leave the room. Soon, the ER doc arrived along with Respiratory Therapy and another nurse or two. I was still bagging. Another person appeared and pushed their way through all of this personnel. I could tell immediately that it was the patient's wife. A nurse tried to tell her to go wait in the waiting room (which I considered a very wrong thing to do). She said that she wasn't going anywhere and asked if we were about to intubate her husband. The ER doc said that we were.
She asked if he would die if we didn't intubate. We replied that he probably would.
She asked if he would die if we did intubate. We replied that he probably would.

She said to stop. The ER doc said, "Are you telling us that you do not want your husband intubated right now?" She nodded.

I stopped bagging and took the mask off of his face. He took a small, shallow breath. He was staring off into space; I don't think he was really there anymore. The wife leaned over him and said she loved him. I asked the nurse nearest to her to put the bed siderail down. The wife hugged her husband as best she could with him lying down.

All I could think was that although that man was surrounded by people, he died alone. For all I know, he was able to hear his wife by the time she arrived into the room. I hope he did.

I'm not saying that we should not have tried to save his life in the days prior by infusing all of those medications. And I'm aware that hindsight is 20/20. I wish, though, that he had been in a quiet room somewhere, surrounded by family. I wish he would have died without a mask on his face.


Thank you to Geena, the prime mover at "Codeblog, Tales of a Nurse". You can find her blog and read more of her musings by clicking Codeblog, tales of a nurse.