Tuesday, December 28, 2004

Christmas Miracle of Redemption.

I recently witnessed a Christmas Miracle, which is another basis for this blog. I'd like to share it with you.

Mr. Ug, which is not his real name, died yesterday. Here is his story.

Mr. Ug is 37. He has, or rather, he had a genetic defect. Too few genes, but perhaps he had too many. I forget, and I don’t want to know, and yet really I do. He had _______ (I’d rather not say). Either way, as a little boy, Mr. Ug made his pediatric geneticist so excited that she included him in some case series or another. In some arcane genetic field, Mr. Ug is celebrated as the only living example of someone whose body is entirely made up of cells that do not have enough of what was previously thought to be vital genetic material. Or rather, he was celebrated.

The lack of this genetic material left Mr. Ug severely retarded, although his pediatric geneticist fought various doctors to have him labeled with the more hopeful term autistic. He was bald except for stringy black hairs that were incredibly long and sprouted from his head at all angles. His hair combined with his very small head to give the look of a thistle or an upswept dandelion. This impression was so strong when I first saw him, it actually crossed my mind to blow his hair-seedlings away. Perhaps they would take up root around the hospital, their genetic material changing further to grow into wonderful flowers. I refrained.

As best as I could figure, Mr. Ug’s lack of genes appeared to tell most of his cells to become cancerous at the age of 36. The cancer either spread nearly everywhere, started nearly everywhere, or some combination. I was never sure. Asking the residents of any specialty or anyone else about this point was entirely futile. Eyes rolled, then glazed, hands supinated, backs turned.

Mr. Ug’s pediatric geneticist, who will be named Dr. Flog to protect the guilty, somehow became fully ingrained in the family’s affairs from the beginning. This involvement increased at logarithmic rates that mirrored logarithmic cancer growth that turned Mr. Ug’s body into cancer. As an adopted family member she made all decisions regarding the care of Mr. Ug. She amazed Mr. Ug’s genetic family with her busy efficiency. They let her tell them what was best, relinquishing all control. I suppose they were tired of it all. I suppose they trusted her.

Mr. Ug was in the last stages by November. I’m not sure how to define futility in general, but I know it when I see it.

When blood stops getting made and this appears to be due to the cancer that no-one can do anything about, one would perhaps consider futility. But, then again, other people can make blood for Mr. Ug. This turned the polls that surrounded Mr. Ug into trees the bore bright red blood berries, and just in time for the Christmas season.

When tumor fills the lung pleura, I think “bad.” Chest tubes are alternative thoughts. CT surgery almost called the entire thing by initially refusing to put them in. But then the argument was made (by one) on a palliative care basis, even though it had no palliative care benefits. And thus the following was shown: you can’t argue against putting a ½ inch thick tube into someone’s chest to somehow ease their suffering without looking like a Nazi-surgeon-psycho. By now Mr. Ug had tubes in every body space. Now he had tubes in potential spaces.

The pneumonia that filled Mr. Ug’s lungs was not helping things. By now Mr. Ug was on 20 odd drugs, full ICU care, and monitoring, and then he got C. diff. When he coded, it took only 2 minutes to bring him back to NSR.

His kidneys stopped and his BP started dipping into the 60s over nothing. Fluids. Drips.

The nurses were nearly in open revolt.

It was the second code, when Mr. Ug seemed to have a seizure, that broke the pediatric geneticist’s resolve. There was something about the possibility of the seizure that made Dr. Flog stop and look: every single organ system was failing. That’s when she finally became a convert to comfort care. The family quickly followed.

The intubation tube came out.

To not make a decision is also a decision. Dr. Flog made two decisions; the latter makes this into my Christmas Miracle of Redemption.

1 Comments:

Blogger The B&G said...

Hiya, just visiting blogs at random. I hate to be rude and not enter without saying hello. So, hello. I love the line you wrote, This impression was so strong when I first saw him, it actually crossed my mind to blow his hair-seedlings away. Perhaps they would take up root around the hospital, their genetic material changing further to grow into wonderful flowers. I refrained.

11:41 AM  

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