Producer Sean Cole introduces us to Joseph Gallo, a doctor and professor at Johns Hopkins University who discovered something striking about what doctors were not willing to do to save their own lives. Ken Murray, a doctor who's written several articles about how doctors think about death, explains that there's a huge gap between what patients expect from life-saving interventions (such as CPR, ventilation, and feeding tubes), and what doctors think of these very same procedures. Preferences of physician-participants for treatment given a scenario of irreversible brain injury without terminal illness. Doctors earn very high incomes, unless in socialized medicine countries, and even then, not too bad return for their education which may not be more than other expertise fields - and so often the Patient is the Last To Know - how to chose or to be able to chose without family pressures and inerference.
Remember family is wanting patient to stay alive for their own consciences, not because of total true love, sometimes out of other benefits, social stigma of looking like they 'dont care enogh' to let patient quit suffering and jus be gone.
As a 40 year old on dialysis who still travels the world, Singapore and South Africa this year, I recommend giving dialysis a try if it's needed.
If I was terminally ill or brain dead or close to it, I wouldn't want to be kept alive by machine.
My dilemma is that my brother is very ill and we have gone over a Personal Directive with him but he says he wants CPR, Ventilator and Feeding Tube and he is already on Dialysis.
At least, by hearing this podcast, the patient took action that got you to actually talk with him, although briefly, about his thoughts on end-of-life.
As for the article that you cited, another physician has already pointed out that it was not what you'd represented. Your program made it sound that being intubated and put on a ventilator is an awful experience. Listened to podcast of "bitter end" last week, and while I agreed with the medical side of the wishes, saw this interesting take on "futile" codes and CPR. It's a hard point to make - that the wishes of the family can, deep down, be very self serving to the family and not the patient, their loved one, the one who they want so very much to stay. Did anyone else notice an analogue to the morality thought experiments in the Morality episode? Paralytics are generally avoided because we know now that the use of them can cause muscle issues after the acute phase of illness is over.
Also, many times families will insist upon the doctor not following a Do Not Resuscitate wish from the patient. I'd much rather have 1 second of pain as the needle goes in than be constantly thirsty and dehydrated.
I made an infographic with some of the data from here and a few other sources - I think all together it's a pretty illuminating look at how Americans plan (or fail to plan) for end-of-life and long-term care. Simone de Beauvoir's "A Very Easy Death" addressed this norm of prolonging death at all costs in medical environments despite the obvious lack of quality or benefit to prolonging it. ASt 73 with a pulmonary artery 96% clogged and depending on one lonely stent, my worst fear [in spite of a DNR and appropriate documentation] what I fear most is falling into the hands of living doctors and as ready hospital staff, anxious to by-pass all my wishes, with which my children agree.
I believe you're misunderstanding the NEJM study, in terms of outcomes after in-hospital cardiac arrest. To quote (but noting the misunderstanding as above):"A study in this weeks New England Journal refutes the premise that resuscitation is pointless (Chan, et. Your readers would probably be interested in this article from The Atlantic about a doctor who's trying to better inform patients and care givers about the reality of treatment options. What if the results are due to the idea that doctors may not want to live with brain damage? Large parts of the data might be due to this rather than being due to the understanding of the invasivity of life-prolonging procedures. I live in the UK and believe here in England we probably have the worst healthcare system apart from third world countries. The whole experience has made me think that I do not want to receive those interventions--yet I am only 42 and nowhere near "dying age." Dying in the hospital is the one thing in this life that scares me the most--the doctor quoted was absolutely right that we wouldn't wish these tortures on our worst enemies.
Funny Remembered QuotesFunny Quotes about RememberedLet these funny Remembered Quotes from my large collection of funny quotes about life add a little humor to your day. With Steven Spielberg's latest movie, War Horse, interest in the real-life horses who experienced the carnage of World War I has been renewed. Grey charger Warrior was injured on the Western Front, but went on to become a much-loved police horse patrolling the streets of Southampton.
Tens of thousands of wild horses passed through the Romsey Remount Depot in Hampshire where they were trained before being shipped to the war fronts.
Whatever we’ve done in this whole so-called automotive “scene”, there’s one undeniable truth: you can never do it alone, and to have friends go along on the ride with you makes it all the more sweet.

To be blunt, and perfectly honest, the ’71 Toyota Corolla you see here is most definitely not the most refined vehicle.
When it came to this hobby that we all know and love, Henry’s friend Armando probably served as his biggest influence. Unfortunately, Henry’s friend never got the opportunity to see his Corolla in person again. The 1971 Corolla Deluxe is a work in progress but to call it a labor of love would truly be an understatement. Traffic cameras in Romania captured footage of a car jumping over a roundabout in the town of Braila. Gran Turismo Sport is the next installment in the popular racing video game series, and it looks like the graphics will be even more photorealistic. But when it comes to the critical question of what to do when death is at hand, there seems to be a gap between what we want doctors to do for us, and what doctors want done for themselves.
As part of the decades-long Johns Hopkins Precursors Study, Gallo found himself asking the study's aging doctor-subjects questions about death. Family is playing the socialized routine of "we did everything we could" especially when they dont pay [much or any] of medical extreme services too. Like most of the people mentioned in this podcast, I have always said I would like to die without pain in my sleep. If you look at your post, you never bothered to discuss end-of-life issues with your patient. Generally speaking we use a sedative such as Propofol and Versed in combination with a pain medication such as Fentanyl.
I will say that if we see a younger patient, we do seem to want more interventions because it is just too cruel.
But I was really unhappy with the comment from one of your guests saying that everyone is paralyzed.
They know how diminished their quality of life would be with such an impairment whereas other people might not understand what implications it holds, making their decisions poor ones. Following dental work I displayed auto-immune problems and have had a strep throat and various episodes of unpleasant issues of joint pain acid re flux and fevers. When you were going through the list of medical interventions in the survey, I was thinking of my father's last four months.
Back then, Armando had a boosted Acura RSX that was all the rage in their circle of friends. Our group of friends was mainly Honda heads but Armando never gave me any grief about getting rid of my Honda. For cardiopulmonary resuscitation (CPR), surgery, and invasive diagnostic testing, no choice for a trial of treatment was given. But, I would have thought I would want everything done possible to keep me alive if something were to happen to me. I can understand going through radiation treatment for cancer if there is a large chance I'll recover. The treatments only have response in 50% of patients after 4-6 mo of chemo and in some clinical trials as high as 70%. The ideal goal is to have an intubated pt awake enough to follow simple commands such as wiggle your toes or squeeze my hand, yet asleep enough to not be really uncomfortable. This has been going on for 4 years and basically they can't find anything wrong with me although I suspect Lupus or some other auto-immune disease.
Usually it is the relative who is not ready to let go, sometimes it is the patient themselves who do not fully understand how invasive it can be to keep someone alive. I was doing my senior practicum for nursing in an ICU and a patient was on an Arctic Sun device, which puts the patient into a hypothermic state after serious cardiac arrest to try and improve their chance of survival..
BakerI would like to be proud of having written some poems that will be remembered,but I will never know whether I will have any reason to be proud of that.- Peter DavisonMartin Luther King Jr.
You could go at it alone and build the hell out of a car—there’s no doubt about that—but then the road to success is a particularly lonely one.
You may see this build and shout out loud that your friend has a Corolla just like this one, that’s way cleaner, has a crazy swap, whatever—it’s probably true, too. It made great power and Armando was never afraid to get on the car and push it to its limits. He was actually pretty excited about it and always wanted me to bring the car around so that he could check it out and drive it if he could.

The 40mm Mikuni carbs and custom side exit exhaust release a deep-toned song that would be music to anyone’s ears, not just Armando’s.
Regardless, it only extends life for 18 to 32 months, though I am told I have a 5 yr average life expectancy. The healthcare system and it's workers does not care for it's patients and basically leaves you to survive or die thinking only of their own paychecks. I have grown and matured and have come to help many elderly people die with the dignity that they deserve. His doctors assured us that he would be just fine in the end, yet one catastrophe after another drew out the agony for months until, naturally, he caught massive infections and died.
As you continue to read on, you will learn to look beyond the car itself and realize what this project truly represents. Around that time in my life I was slowly losing interest in the whole car scene though so I kind of put the Corolla on the backburner and didn’t really do anything to it. Every time Henry hops into his Corolla and mashes on the pedal, it’s a screaming proclamation that his dear friend will never be forgotten. In this study of 6972 patients who had a cardiac arrest while in the hospital 82% were alive at 30 days and 45% at three years. It is so, so important to give these people all the necessary information and truth they need during this process - no matter how awkward or sensitive the subject matter.
Many of the friendships and relationships that you develop along the way will exist long after any car build, and most certainly long after your car crew breaks up. This Corolla, owned by Henry Mendez, is rough around the edges because it sat dormant inside a garage for years.
After I rode in it, I wanted to do all kinds of stuff to my Civic just so I could catch up with him. Armando was survived not only by his mother, father, and sister, but also a group of friends that thought the world of him.
I have an Advanced Directive, one which I had to fight my doctor to accept - no resuscitation, no antibiotics, no heroic measures. Even though I am a healthy 27 year old - I completely agree with the doctors in this podcast.
It’s a cool and amazing thing to be able to share a mutual interest with people in your life that matter.
Today it sees life again on the streets of Southern California because it serves as a rolling tribute to a great friend.
The way he lived his life inspired the people around him to live every day of their lives in his memory. I feel like having someone's life prolonged like that isn't about keeping them alive but mostly about the family members who aren't ready to let go. While you will be able to view the content of this page in your current browser, you will not be able to get the full visual experience.
I would tell him that I had plans to take it to the shop and get it fixed so that he could see the car,” Henry says. At his funeral services, all of his friends brought their project cars out of respect because they knew that he would not have it any other way. I am feeling mostly fine, much better than before the alternative treatments, when I was having many infections. Please consider upgrading your browser software or enabling style sheets (CSS) if you are able to do so.
The sheer number of cars that came out that day would rival some of SoCal’s best car meets. For Henry Mendez, his way of dealing with the passing of his friend would be to resurrect his Corolla in Armando’s honor. I am having a hard time identifying if the doctors are recommending treatment because they don't know what else to do or if they actually think it improves life erxpectancy at a quality level or if it is just a chance with poor response rates. Im just glad at the end, she was given more medication to pass through more peacefully after such interventions. Do any oncology nurses or MD's who are reading this have professional opinions about whether Vidaza treatments are worthwhile in any way other than to "possibly" extend life and at what quality of life?

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