My Battle with Merkel Cell Cancer

We got word that the ER doctor wanted to admit him to the ICU, but they first whisked
him off to x-ray.
** Email: Date: Wed, 18 Apr 2012 12:07:28 -0700
Subject: Re: Update 1206
On his way to X-ray.
ER doctor wants him admitted to ICU. we'll see if there is an available bed. **
The doctor came in and I asked him to ask my dad for his specific DNR and related
instructions. I was aware that my mom and I knew them, but I knew they would be
followed more accurately if given directly by the patient. It also would save my mom, if it
came down to it, from having to say the words that dad would have wanted her to say but
that would be very hard to actually say with regard to somebody she's loved for over 50
years. I also recognize that writing instructions in a lawyer's office, or even discussing
them in the abstract even in a hospital bed, is only a simulation. When faced with the
reality that the instructions are likely to actually be followed that day, people often need to
tweak their instructions.
He said he did not want to be resuscitated "ever", regardless of the event or the severity
of the event. I got him to clarify whether he would want to be resuscitated even in the
event of a minor event, and he said "no" with clarity and purpose.
** Email: Date: Wed, 18 Apr 2012 12:31:43 -0700
Subject: Update 12:28
He has been admitted to ICU.
he just gave the doctor an order that he does not want to be resuscitated "ever"
regardless of the event, respiratory, cardiac or otherwise. So given he has abnormal
cardiac rhythm, terrible O2 sat, probably needs to be intimated [SIC, should be
intubated], and has tumor impinging his lung, the DNR instruction gives a very high risk of
death in the next few hours or days. A hope I'm wrong.
Sent from my iPhone **
The x-ray came back around 12:15. I don't recall dad reading it himself, it is one of the
few memories that aren't still totally clear for me:
** Email: Date: Wed, 18 Apr 2012 12:22:16 -0700
Subject: Update 12:20
Dad read his own chest X-ray. Described it as bad, bilateral pneumonia.
I'd be shocked if he isn't in the ICU overnight.
Sent from my iPhone **
My dad was visited by the doctor who was to admit him to the ICU. I prompted this doctor
to make sure he knew my dad's wishes, and to ask my dad directly. He did:
** Email: Date: Wed, 18 Apr 2012 12:58:57 -0700
Subject: Re: Update 12:58 bad news. Possible rapid development.
He just refused intubation. He instructed doctor "instead of intubating me, just shut me
down with morphine. I've just about had it. I've had enough."
He is giving instructions that make it highly likely he will not live much longer.
My Battle with Merkel Cell Cancer
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