It was my first day at my new job, practicing a new specialty. Having spent fourteen years as an ICU physician — including a four-year pulmonary/critical-care fellowship in this very hospital — I had just completed a palliative care fellowship. Now I was the hospital’s palliative care consult attending.

When I set eyes on the patient in room 1407, my first thought was: THIS LADY NEEDS TO BE INTUBATED, STAT!

The only trouble was that my job was to ease this patient’s passing, not to prolong her life.

The team had told me that Mrs. Zelnick, an eighty-two-year-old widow, was dying from pneumonia and didn’t want to be put on life support.

What a breath of fresh air, I’d thought. Too often, as an ICU physician, I’d been tasked with keeping dying patients alive — here, I was being asked to honor an elderly woman’s request to die in peace.

Mrs. Zelnick, a beautiful woman who bore a striking resemblance to Anne Bancroft, somehow remained elegant even in her distress.

Her chart documented a surprisingly benign medical history: she’d suffered no real medical problems until a few days back, when she’d been brought to the emergency room for a bowel obstruction.

Over the next three days, while the obstruction was clearing up, a pneumonia had blossomed.

Now I noted Mrs. Zelnick’s confusion, rattling breath and blue lips — clear signals of respiratory distress. This was not good.

A Filipino woman sat at the bedside, crying softly.

I introduced myself and asked, “How do you know Mrs. Zelnick?”

In faltering English, she explained that she had been Mrs. Zelnick’s housekeeper for the past eight years. When Mr. Zelnick had died, three years ago, she had moved into the home at Mrs. Zelnick’s request.

“She was all alone. Lonely. When he died, she had no children, no friends. She was always so sad and didn’t want to talk much. I tried to cheer her up, but …” She shrugged sadly, then lifted up Mrs. Zelnick’s forearm and pointed to a line of numbers tattooed on the inner side.

My heart dropped. This woman was a Holocaust survivor. She looked like my grandmother, the archtypal Jewish grandmother. Something inside me melted. I wanted to pick her up, to cradle her. I longed to shield her with my own body from all her suffering, past and present.

And I didn’t yet know the half of it.  (…) Read Full Article Here

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