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The Drip

I’m admittedly passionate about what I do. I know that it bothers me fundamentally to see people suffer in illness. That is why I am a big advocate of aggressive end of life care like drips. That means infusions of mainly narcotics to help manage the suffering of pain and respiratory failure.

It’s so easy to get caught up in the (false) mentality that dying is simple, that it doesn’t need much. As each patient and family’s experience of dying is unique, their own, they in their own world don’t see the wide breadth of forms of dying that I see. They don’t know that the next patient admitted will have respiratory failure, breathing at fifty-two breaths per minute (normal is eight to twelve), and making guttural noises, grunting to assist in any way to gain a meager percentage of extra force to continue the arduous and desperate work of breathing. They don’t know that the patient with metastatic cancer right after that, has had unmanaged, off-the-charts pain for the last twelve months, and now has a blistering paraneoplastic rash to his bilateral lower extremities that oozes searingly when the blisters burst, complicated by bilateral deep venous thromboses which have compromised his circulation. To simply touch him is to induce tears.

So, imagine how demoralized one could get in hearing, as I have, that a service “doesn’t do drips,” or “doesn’t feel they are necessary,” or the implication is that they simply cost too much – which they don’t if they’re implemented in a timely fashion instead of futzing around with unwieldy and failing regimens. I am disappointed to hear these utterances because I know that nothing else feels worse in life than unremitting pain – that is why we fear death so much. And that having been in excruciating pain myself, I know that one can’t remotely begin to concentrate on anything else except that when one has it. So please, for any person so cavalier as to think we don’t need to pull out all the stops at the end of life where we get one shot to avail ourselves of peace, put yourself into those two patient’s shoes. You’d want that drip, too.

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