Just Live

Chapter 28

"Doc, it's been a week, my daughter still hasn't woken up."

"I'm sorry, Gelli. I know we're all eager for Sarah to wake up but unfortunately, that's not in our hands anymore. We are doing everything we can to prevent complications but there's only so much that we can do. What little progress we made this past week is gone. We have no control over how her body will respond to our treatments."

After they were told that Sarah's lungs were beginning to respond to treatment, the good news stopped there. She has not shown improvement since and her oxygen demands remained the same, meaning the treatment has not been effective. Sarah continues to fully rely on the ventilator for breathing while her other organs are on the brink of failing.

Gelli let out a long breath and looked at her husband for comfort, which Ariel gave by holding her hand tightly.

"Gelli, Ariel, I do have something to talk to you about," the doctor said.

When Sarah's parents nodded and remained quiet, the doctor proceeded with discussing a matter no parent should have to think about.

"Given Sarah's current state and the lack of good progress, we have to discuss your daughter's goals of care status and health care directive."

Furrowing his eyebrows in confusion and frustration, it was Ariel who spoke up first.

"Doc, what is there to talk about?" He asked with heavy breathing. It was definitely a conversation they were not prepared to have.

"Sarah's goals of care is currently an R, meaning she's a full code. Should anything happen, for example, if she were to code and go into cardiac arrest again, we will do everything we can to resuscitate her back to life, though that's never guaranteed. We all know that she's not responding to treatment as well as we're all hoping for but we are continuing with an aggressive approach. At this point, her prognosis is not looking too good as she's not improving. If you feel it's time to change that approach and you want to change the priority, we can talk about changing her goals of care. We can continue a medical approach where we continue with all the treatments but if she deteriorates further and her heart stops, there will be no attempts of resuscitation. Or, if you feel that you're ready to prioritize her comfort over treatment, we can change the goal to comfort care. Our focus then will shift from actively treating her to stopping the treatments and concentrating on end-of-life care, making sure she's as comfortable as she can be."

The doctor's words felt as though they weighed a ton, crushing their hearts as they were forced to consider a painful possibility.

"Doc, I appreciate you checking in with us on that matter, but we are not changing my daughter's goals of care. Not when our daughter still continues to fight through every setback," Sarah's father replied with increased breathing. "She may not be responding the way we want her to, but she's still here and she's still fighting."

The doctor nodded at her parents in understanding and looked them in the eyes. "You have a fighter," he commented with a compassionate smile. "I try to keep all of us on the same page so I know that you are aware of the possibilities from this point on. Should anything happen and Sarah continues to go downhill, I need you to know that she put both of you in the authority to make decisions for her. We'll be here to give you as much support as we can to help you make informed decisions for Sarah. I'm sorry we had to have this conversation, Gelli, Ariel, but it was necessary given her status. We're still doing everything with Sarah's best interest in our minds."

Ariel swallowed the lump in his throat and shut his eyes as he looked away. He took a deep breath in an attempt to control his emotions. To say that they have been worried about their daughter is an understatement since Sarah's condition has been unstable in the last few days, making them all anxious and fearful of every change in her status. He gently rubbed his wife's back and Gelli took a deep breath while leaning on her husband.