01/19/2015 Meeting the Treatment Team: The Fantastic Four–Part II

When last we left off, our second member of the team, Mary Ann the nurse, had just knocked on the front door. The demon dogs, who’d just settled into their naps, were now voicing their concerns about another stranger’s presence. Since I assumed the dogs would be even more riled up now, I upped the ante dog-treat wise. I’d been soaking elk antlers in chicken broth in my fridge overnight(never in my life did I think I’d see those words in the same sentence.) I scooped two slippery elk antlers out of the pyrex bowl and dashed to the front door. I opened the door with my slightly salty elk antler hands and greeted Mary Ann with an apology before even introducing myself. “Sorry, I have antlers in my hand and they’re wet so I don’t think you want to shake my hands. I need to shut the dogs up and Tracy’s in the dining room.” I’m pretty sure Mary Ann thought I’d been dipping into Jamey’s medical marijuana stash(no, he doesn’t really have any medical marijuana–you can stop thinking about how you can fake a visit to my house just to steal some.) Mary Ann starts asking Jamey questions that echo the ones Tracy had asked. Even though he lacks a short-term memory most of the time, he remembers that these questions seem familiar. I can tell he’s getting agitated again since he goes back to picking tiny fibers off the table runner. I give them both a brief overview of the last 7 years(3 craniotomies, temodar, he’s beaten the odds, blah..blah…blah) Then they came to a question that stopped me in my tracks. They asked us both if Jamey had a DNR. He immediately wanted to know what DNR meant. I knew what it felt like it meant–Damnit, Not Ready” I wasn’t ready to talk about that yet, but Tracy decided to explain it to Jamey. She put it in simple terms, “If an ambulance is called to your house because your heart has stopped and you’re no longer breathing, would you want them to start your heart again with CPR or would you be ok with them doing nothing?” Jamey Spock-cocked his eyebrow in disbelief and huffed, “Seriously? Of course I’d want them to give me CPR! Who wouldn’t?” Tracy nodded and told him that was his right as the patient, and that if he wanted CPR, then no DNR form was necessary. I sat, mute, widened eyes darting between the two workers trying to silently get their attention. As much as Jamey avoided most conversations about end-of-life decisions even when he was aware and “himself”, a few years back I had needled him to the point of discussing the unpleasant realities of brain tumor diagnoses. Thanks to our neighbor, Kelly, we’d gotten a will drawn up relatively soon after his diagnosis(to avoid Kelly “putting her foot in our asses if we didn’t.”) While with the lawyer, we were forced to talk/think about issues like powers of attorney/durable medical powers of attorney, guardians for Caeley etc. I knew the old Jamey would want a DNR. I also knew the old Jamey would be able to understand the full scope of what Tracy was asking him, much like you all do. Jamey now, however, can not currently understand this. I finally spoke up and explained that I had medical power of attorney rights and I would like the DNR. And I felt like a Nazi doing so. It’s one thing to make a decision when it’s your own life. It’s entirely different when you have to make that decision about another human. A few weeks back, I decided to euthanize my cat. She likely had a brain tumor(ironic, I know) or leukemia–she was pretty close to death and her symptoms came up suddenly. Caeley wasn’t home when I took her to the vet to be put down. When I met Caeley at the school bus at the end of the day, she asked me if Luci(the cat) had died while she was in school. I told her I’d had her euthanized. She dispassionately stated that I was “basically a murderer” since I made the decision to put her down. I pointed out that the vet was more complicit than I since she gave the actual injection. But I guess one could argue that the vet was “just following orders”–my orders. If Jamey’s heart were to stop and the EMTs rushed into our kitchen and read the DNR order on our fridge (hanging next to Caeley’s “Student of the Month” certificate, several Chinese food menus and a Commerce Bank bake-off magnet), they’d be following orders as well–my orders. Tracy asked to see a copy of the will to make sure I was able to act on his behalf. I was, and Tracy placed it in her folder to be forwarded to the agency’s physician. I felt so dirty, until I saw the looks of understanding on both of their faces. Without saying a word, they acknowledged how uncomfortable this was for me. I swear if I’m going to hell for initiating this DNR order, I am going to kill Jamey. Stay tuned for Part III of this blog–meeting the woman who “sits and stares at Jamey while he showers.”

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FYI–I’m pretty sure a DNR tattoo isn’t an official document. I was surprised how many older folks have DNR tattoos! Get googling!

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