Should all patients be resuscitated?

Wendy Veitch is a guest on tonight's episode of Insight.

Wendy Veitch is a guest on tonight's episode of Insight. Photo: SBS

My view on resuscitating people changed when my brother, Trevor, suffered a cardiac arrest in the first quarter of an AFL match.

Once the paramedics arrived, it took a long time to descend from the high stadium seats Trevor had been so pleased about obtaining for the match between St Kilda and Geelong. His heart had stopped for more than 40 minutes and we were all completely behind his medical team in their fight to “bring him back”. It was traumatic watching him lying in ICU with tubes all over the place, machines bleeping and nurses constantly monitoring everything, but all we could think was, “Please save him!”

Even after he started breathing, we still had no idea whether we would ever see the Trevor we knew again, nor did the doctors. Being told that he had a “severe hypoxic brain injury” meant nothing to us. We just wanted to know basic stuff like whether he would be able to walk, talk, speak and understand us. I feel awful saying this now, but we may have been told the full extent of what could happen to him if he pulled through. None of us can remember – we just wanted him to live, and this would come back to haunt us.

Wendy's brother Trevor.

Wendy's brother Trevor. Photo: SBS

Trevor spent three and a half months in hospital. Part of the recovery process of brain damage is major mood swings that include frustration and aggression. I could never get used to seeing him restrained in his bed, but after being subjected to a headlock and then an attempt to smash my head into a wall, I accepted that it was necessary for everyone’s safety.

Trevor was moved to a rehabilitation centre and we thought everything would begin to improve. He could walk, eat his own meals, was starting to dress himself and look after his own grooming. But his brain injury had left Trevor with aphasia. He had trouble getting the words he wanted to say out in the right order. By constantly showing him photos of his life and then introducing words to match them, Trevor began to figure out a ways to communicate with us.

Suddenly everything started to go downhill medically. Trevor’s bowel shut down and he went from 103kgs to 73kgs in a couple of months. He was slowly dying before our eyes. We had to pay a carer to sit with him and assist with his meals to ensure he received the nutrition he needed.

Trevor needs a carer to sit with him and assist with his meals.

Trevor needs a carer to sit with him and assist with his meals. Photo: SBS

The rehabilitation centre insisted that Trevor be moved elsewhere as they didn't feel he could improve any further. Trevor moved into an aged care facility because nowhere else could provide the level of support and care he now required. Trevor was once a “chick magnet” with plenty of friends and a busy social life – now he lives in an aged care facility at the young age of 55.

There is simply no funding to support people like Trevor, and Victoria’s Department of Human Services now has a policy where those under 50 years get priority of access to service and jump over Trevor in the queue. He is effectively denied any chance of getting the support he needs to live in the community and he was just past his 51st birthday when he had his cardiac arrest.

My attitude about resuscitation has changed completely after seeing what has happened to Trevor since he was “brought back”. At the time we desperately wanted Trevor to live – at any cost. Even though he appears happy enough in himself, I now look back and wonder whether the right thing was done for him. I love Trevor with all my heart but I just know he wouldn’t really want to live like this.

Having seen Trevor’s outcome, I have told my husband that if he if ever comes home and finds me having a heart attack, I want him to go back out again and come home in a few hours. I would not want to live like Trevor, and I would not want my husband to give up his life to visit me every week if the same thing happened to me.

Some people are very lucky and come back after “dying” with little or no damage, and they are able to continue on with their lives. Perhaps if Trevor had received the intensive rehabilitation therapies he needed early on, he may well have been further along the road to recovery.

Was it right to prolong Trevor’s life if this is all it is going to be with what the State system offers? If I had a choice now, the answer would be a definite, “NO”.

Wendy Veitch is a guest on tonight's episode of Insight on SBS ONE at 8.30pm. The program explores how medical science is pushing the boundaries of death, with doctors now to able to resuscitate some patients even an hour after they have 'died'.  Speaking to people who have ‘come back from the dead’ and doctors with conflicting viewpoints, Insight asks whether we should be reviving people just because we can.

 

38 comments

  • As a healthy 35 year old woman, I have no wish whatsoever to be resuscitated into a life of needing constant care. My husband feels the same. It was be good for people to be able to make their feelings known about this, in the same way as donor registration, perhaps a national DNR register. It's not a nice thing for families to have to think about, but an important conversation to have with loved ones nonetheless.

    Commenter
    om
    Date and time
    August 06, 2013, 9:18AM
    • I'm not sure how it would have applied in this case but having an Advance Health Directive means that you can dictate what your wishes are with regards to medical treatement in the event of you being unable to make a reasonable judgement. As part of this you can specify that you do not wish to be resuscitated. My mother who is an ex GP has one which specifies this, she has no wish to end up in a vegetative state. What Australia needs as well is legalised euthanasia, it is ia travesty that people are unable to decide when and how to end their lives and that those who assist them are liable to criminal charges.

      Commenter
      Hurrow
      Date and time
      August 06, 2013, 9:25AM
      • Why portray the lack of a green light for legally allowing one person to kill another as a travesty?

        I personally do not agree with you. That 'doesn't mean' though that I'm incapable of empathising with other peoples suffering. I think portraying it as a travesty conjurs the perception that legalising euthenasia is the only decent course of action, or the one immutably obvious as the only legitimate choice.

        I have concerns with legalised euthenasia and the empowerment of an individual to legally kill people who ask to be killed by the state.

        Euthenasia is an entirely different proposition from a person making an informed and legally binding choice that they do not wish to be resuscitated. I may be wrong but I think even the right to terminate a pregnancy is ONLY on the proviso that the mothers health is at risk.

        The society in which we live seems to have the legal view that no one else can deliberately take away anyone elses life without facing serious sanction. If there is a travesty it's those who get found guilty of culpable driving yet never serve jail time.

        I think Wendy could consider looking at what happened to her brother in a different way. Rather than focus on the outcome of his resuscitation and applying it to any other possible scenario take heart in the ongoing demonstration of a comittment to value her brothers life.

        Our default position in a community ought to be that injured people get resuscitated. I just see nothing simple about any of this and I don't trust our 'best intentions' or 'love' as guides for our ethical compasses.

        Commenter
        MattG
        Date and time
        August 06, 2013, 10:44PM
    • I resucitated my mother whe her heart stopped in our bathroom and twice after at the hospital she died and was resucitated. Thankfully she recovered and is living her life as if her "deaths" had never happened - except she now has a dual pacemaker (and will probably live long enough to nag my daughter when she's an adult :P)

      The difference between my mother and Wendy's brother is that I and the paramedics, got my mother's heart started within ten minutes of it stopping completely. I truly believe time is the key to brain damage when the heart stops and is started again. So while I can totally appreciate what Wendy is saying, and have often said to my daughter not to try to save me if I cannot be resucitated within 15 minutes, I think the deciding factor is that it was over 40 minutes till Trevor's heart was started again. I would like to think that Wendy would allow that option within a realistic time frame, but I totally respect and understand her decision to not even consider it.

      I hope that Wendy and her family can find some peace in relation to their decision with Trevor and I applaud her courage to tell this story with frank honesty.

      Commenter
      Dhammachick
      Location
      Sydney
      Date and time
      August 06, 2013, 9:43AM
      • This is a sad experience to read about, however, many people are resuscitated and make full recoveries.

        There is no way of knowing if a person will make a full, partial or slight recovery from a thing like this - the only thing to do at the time is act.

        While I am sure there are other harrowing experiences such as this, there are many families out there who are grateful that their mother/father/brother/sister is now alive thanks to somebody who resuscitated them.

        Commenter
        Adrian
        Location
        Sydney
        Date and time
        August 06, 2013, 9:47AM
        • 'There is no way of knowing if a person will make a full, partial or slight recovery from a thing like this'

          While this is true, the chances of someone making anything other than minimal recovery from FORTY MINUTES of downtime are slim indeed

          Commenter
          Sir Lolsworthy
          Date and time
          August 06, 2013, 1:12PM
        • The chances of recovery from an out of hospital cardiac arrest are slim at best however I have learnt over the years that you can't tell who will survive v who will survive with good quality of life. Time is a factor but it's not the only factor, 10 minutes is too long for many, a few recover well after much longer. The point is who is going to judge? As Wendy said, at the time she wanted everything done so her brother might recover, in my experience that is what most families want - they want a chance at life.

          The pedant in me wants to point out to a few posters that a heart attack is not the same as a cardiac arrest. Careful what you put in your advance directives...

          Commenter
          Crossword
          Location
          Square 1
          Date and time
          August 06, 2013, 5:55PM
        • Many people are resuscitated and most of them ultimately die or end up disabled in the end. Most do not leave hospital. Many end up brain damaged.

          I do agree that if you are there, then you must act. Perhaps the person will make a full recovery. Most don't.

          Commenter
          Jane Doe, a Deer a Female Deer
          Date and time
          August 06, 2013, 9:06PM
        • I think the point of the article was not to stop paramedics from resuscitating people but a plea for more support from the tax payers when that person turns out brain damaged. They would rather bury their loved one that see him or her whittle away slowly. It drains people emotionally as well as financially.
          Here's the thing, it's not just those who have suffered brain damage who fit this category. It includes all of us growing old. Our brains may or may not deteriorate but physically, we will and we too will be a burden to our loved ones and they will secretly wish we die soon rather than be such a burden. Or alternatively, we would wish we went quickly so as not to burden our loved ones.
          This article is dangerous. Life is a blessing in whatever form.

          Commenter
          Knee Jerk
          Location
          Sydney
          Date and time
          August 07, 2013, 8:41AM
      • This is a difficult subject. I too have heart problems and nearly asked my son to walk away and come back in a few hours if/when I have a heart attack.....but didn't. He wouldn't do it, his first instinct would be to save my life and then deal with the consequences and I have finally made peace with this fact. It is different for everybody and this is our way. Life is never easy.

        Commenter
        M
        Date and time
        August 06, 2013, 10:19AM

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