I was inspired to some degree by one of those end-of-life for "Aunt Mary" dilemma's, that cross our threshold frequently.

If only John Q. Public would get a clue: Look, when you're over 50, you have the "big-three" of CAD, Diabetes and HTN, and you're in piss-poor every-day health, and then you drop over dead, CPR x 1 hour, portends no more than a 1% likely-hood of survival. And even then, that's probably a very generous outlook. But, during that aggressive hour of resuscitation (and just why?!? did it last that long?) you do receive a boatload of powerful chemicals that just might.........initiate some last-ditch electrical activity in your heart. Well, it's tough for a physician to stand around and wait for the heart to stop (again). So, put Aunt Mary on a respirator and treat her as though she has more than a snowballs chance in Hell to survive. Believe me, even the all-powerful Sister Euphemia can't intercede at this point.

The only hope is that JESUS, will intercede, and raise the dead.

Frankly, I feel kind of sorry for that dude. There he was, hanging around in the ER, with his arms outspread to hug and welcome Aunt Mary, into his heavenly fold. And then, damn, there is that freakin' strong epinephrine stuff coursing in her nearly dead veins, and there is nothin' he can do about it! This is a moral dilemma for Jesus. He and Aunt Mary had this pact, that if she were to ever have a cardiac arrest, he would be there at a moments notice, to usher her to the other side. Now, it's as though she is being held back by some puny little humans, and it is outside of his job description to kill her, to be able to keep her, so to speak!?!

Now he is definitely between a pillar of salt and the dead sea. We caregivers are just following directions. We and the doctors have that Hippocratic Oath to "do no harm". So, we forge ahead and follow the family wishes (no matter how bizarre), because Aunt Mary, no longer can speak for herself. By this time, Jesus has split, and just maybe, he has told one of his groupies to hang around the hospital room, and keep him posted with daily updates. However, once Jesus takes off for other more pressing demands, that is when the Grim Reaper starts hanging around. Who knows what his intentions are?

And that's how I got here:

The Work of Jesus

I'm ever more astonished
At the work, Jesus is expected to do,
Forecasting that he will heal
When really, death is due.

Take this patient in the corner
As example number one,
Her heart, her lungs and kidneys
Were very nearly done,
When a cardiac arrest
Knocked her to the floor,
Giving her tired soul a chance
To slip right out the door.

She had CPR
For well beyond an hour,
Where the medical team performed
Everything within their power,
But they finally reached consensus
That there was nothing more to do,
When lo and behold, her heartbeat
Went from straight-line to forty-two.

Now she’s grazing in our unit
Life-supported to the nines,
Seven vasopressors
And thirteen central lines,
An ET tube, an NG sump
And the Foley-Temp-Deluxe,
And while it seems we're doing everything
She's a DNR, oh shucks.

We finally get to Jesus
His role in this whole caper,
The family expects a miracle
According to the paper,
Written by some disciple
Two centuries post-resurrection,
How Jesus will raise the dead again
Like some cosmic lottery selection.

There are just too many people
Who need that Lazarus link,
Jesus can't heal every one
So do not even think,
That your sweet old Aunt Jemima
Is on the Jesus list today,
She tried to depart a week ago
Till epinephrine, made her stay.

The truth regarding dear old auntie
Is that she'll never get restarted,
Her body is here, and her brain is dead
While her soul has already departed,
The resident of this ICU bed
Could be likened to an empty shell,
Auntie is firmly ensconced in heaven
While her body remains here in Hell.











Fibril_late;
10/7/08