This story was written by sophomore Rhys Cadorette, as a part of a collection of stories about moral dilemmas in our community.
Would you rather be hooked up to machines for the rest of your life, or die knowing you wouldn’t be in constant agony? Most people would choose to take all life saving measures, while a handful of people would rather die doing what they love. In June of 2020 an ambulance arrived at Dartmouth-Hitchcock. In that ambulance there was a seriously ill cancer patient. “She was very clearly actively dying,” said Laine Nicole, an LPN at the time.
Laine N. was an LPN at Dartmouth for a little over a year. She got her nursing degree at VTC. Before her time at Dartmouth she worked as an EMT all over VT and NH. Way before that she was a travel nurse. She is currently going to the University of Indiana for her Bachelor’s in Nursing (BSN).
Laine was working in the ER when the patient came in. She noticed that the patient was a regular. The patient was at Dartmouth the other day getting treated for cancer. Laine also knew that she had a DNR. But the patient was unresponsive. When a patient is unresponsive and can’t talk for themselves the hospital has to call their durable power of attorney and ask them if they wish to let them go. Until they see the papers or call the durable power of attorney they have to perform CPR. The second the DNR goes they can stop CPR. Which is a very difficult decision.
In this case the patient had appointed her 4 children her durable power of attorney. They all came to an agreement. “She was just playing golf with us this morning and she was fine.” “We do not wish to let her go, please save her.” The staff of the hospital knew that they would have to do all these invasive procedures that this patient clearly didn’t want since she signed a DNR.
Here’s the awful part: 8 out of 10 patients who are resuscitated will be in a coma and sustain some level of brain damage. Simply put the longer a patient goes without oxygen the worse the damage will be. When the patient was in a coma and obviously not able to care for herself the health care workers have to monitor her. They keep the patient’s temperature 32-36 C for 24 hours. They also monitor EEG (a test that detects abnormalities in your brain waves) and assess for inconclusive seizures (they must treat them if present in this case the patient did not have them). After you must obtain a head CT (computed tomography, x-ray of your brain used to assess head injuries). Once done testing for head trauma the patient is still in a coma so the hospital is responsible for maintaining oxygen, glucose, carbon dioxide, etc.. The hospital is also responsible for the patients nutrients, inputs and outputs (catheters ETc..)
While the medical team at Dartmouth was performing these invasive procedures. The patient’s health was declining rapidly. “It was horrific and I felt like a monster.” Laine said “I knew what I was doing was wrong, but there [wasn’t] anything I could do.” Shortly after the patient was stable she rapidly declined again. But this time there was no saving her.
She had died in an even worse way. She could’ve died peacefully, but due to her children choosing her to live she had to fight a battle she already lost. “Choose your durable power wisely. Make sure they respect your wishes and understand you would rather die peacefully doing what you love than having a low quality of life hooked up to machines.”
