Hope is expensive, even in medicine - East Valley Tribune: Business

Hope is expensive, even in medicine

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Posted: Tuesday, March 22, 2005 5:29 am | Updated: 9:55 am, Fri Oct 7, 2011.

As I walked out of the neurological intensive care unit, my eyes met the eyes of the wife, the son and the daughter.

Minutes before, they were told that Dad was being taken off life support. Now he had expired.

It was just before dawn on a Sunday morning. Exhausted from a weekend of running errands at Good Samaritan Hospital in Phoenix, I was the last of the code arrest team to leave the unit.

The family members’ gazes locked on me. They seemed to be searching my eyes for an answer. They seemed to see something besides a 23-yearold go-fer in a blue smock. Maybe I was a doctor. Maybe I had good news or a second opinion. Maybe there was still a chance that this nightmare — Dad had been shot in the head Friday night after a bar room argument — would end differently.

I looked away. They had their answer.

From 1980-82, I worked at Good Samaritan Hospital in Phoenix. I learned our bodies do not give up the ghost easily. People die hard.

Hope dies harder.

Especially for a family.

And often at great financial cost. Right now, there’s a battle going on in Florida over the right of a brain-damaged woman in a coma to die. Or rather her husband’s right to take her off a feeding tube vs. her parents’ right to keep her on it.

President Bush and Congress have taken the extraordinary step of passing a law that makes this fight a federal case.

President Bush has tried to rein in medical costs, mostly by pushing for tort reform that would cap awards in medical malpractice suits. But I can tell you as a former ground-level observer that carrying on after all medical hope is gone makes the bills mount.

No one can or should put a dollar amount on a human life. And we should do everything possible to save a person.

But what if we are beyond any rational shred of hope?

The decision is left to the family. In practical terms, any significant family member can veto the decision to end it.

During my time at Good Samaritan, I often would see family members plead with each other over whether it was time to let the suffering stop after the doctors said there was no reason to continue.

Sometimes the pleading turned into screaming.

Meanwhile, the meter was running for ’round the clock care.

When a patient went into respiratory or cardiac failure — a code arrest — my department was responsible for bringing the code cart.

It was an auto mechanic’s tool chest filled with medical supplies, mounted on wheels and topped off with a defibrillator.

Somebody in central supply told me the patient was billed $130 ($386 in today’s money) every time we wheeled that cart out. It was more if any of the supplies were used. And the cart and the stuff in it were relatively cheap.

Miracles do happen of course.

But I want to give you a sense of the odds. I went on dozens of code arrests — 60, 70, maybe more.

Not one of those patients ever checked out of Good Samaritan Hospital.

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