what a way to go

I took care of a near-drowning victim yesterday that was 95. I know, right? At least 3 people in the room said, well, I hope I’m still swimming when I’m 95. She looked like a skinny wet little chick that had been just hatched from an egg… no teeth, short, thin grey hair that smelled like chlorine. She looked like a spunky old gal. I got the story from her caregiver who said that, no she hadn’t been at an aerobics class or anything typical you would think of for miami beach retirees, but swimming laps in the pool by herself. She just stopped swimming in the middle of the pool, and it took a few minutes to get her out, do CPR, call EMS, etc. She was barely alive when we got her in the ER, and after we intubated her (i.e. put a tube down her throat to breathe for her), I reflected that she will probably never be extubated. Maybe I’m wrong, but she will most likely spend the next few days petering out (and yes, we callous people call that “circling the drain”) in the ICU and finally die.

Yesterday was nuts and I was so wiped out when I got home that I fell asleep on the couch at 8:30 and was prodded up the stairs to bed at around 10. When I go to sleep too soon after getting home, I tend to process work in my sleep, which meant a really restless night, and I woke up thinking about this lady this morning. Most of the near-drownings I have seen have been in my pediatric ER years, and usually are far more traumatic… there is something about a child drowning– the kid was happy, playing in the pool, just fine that morning, and now they are either dead or on a ventilator in the ICU and maybe/probably headed for a life with some sort of brain damage. Hysterical parents are typically involved. Watching a 95-year old lady go down that road was very different, and actually kind of a relief to see someone die that had an active life up until the week that she died. It makes me feel better about the prospect of getting old, as opposed to the other scenarios that just make me scared to have children lest something awful happen to them. So, although there are a lot of things to not like about geriatric ER, this is not one of them.