A party before dying.

摘要

I met Joe the way I meet all of my patients: His name appeared on my daily hospitalist list. He was an intensive care unit transfer, recovering from hypercarbic respiratory failure related to chronic obstructive pulmonary disease, congestive heart failure,, and deconditioning after recent aortic valve surgery. Joe was 80 years old, very pleasant, and thin. He and his wife were looking forward to transferring to a rehabilitation facility and ultimately going home. But this was not to be. Over the next month, multiple complications-aspiration pneumonia, recurrent heart failure, poor nutrition, worsening deconditioning-culminated in repeated episodes of respiratory failure. Joe was clearly dying.