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Wed Dec 20 08:43:22 GMT 2006

oded private,

First of all, I must tell you that I love your name. You would never get lost in America with a name like oded private. Sounds like a rock star's name. 

Resuscitating a person who may/is likely to have brain damage is the most challenging decision for the resuscitologist. I like to look at problems logically, and put myself in the place of the victim. Here are some of the possible situations if you successfully resuscitate me. First, let's assume that I'm resuscitated, spend a week in ICU, a week on Step-Down, 1 to 2 weeks on the floor, then...1) I go home to my family, return to work, and enjoy intelligent interaction with humanity until something else gets me 30 years later, or 2) I go home to my family, can't return to work, drains the family estate to the point of financial ruin until something gets me 20 years later, or 3) I go to the rehabilitation center, return home to my family, can't work, drains the family estate, and die of alcoholism 10 years later, or 4) I go to the rehabilitation center, get a feeding tube in my belly, drains the family estate, and die of pulmpnary embolism 5 years later (I really hate all of humanit
y by now), or, if there is a God and I am deserving of his attention: 5) I died from my injuries. The physician decides that quality life was no longer possible for me, based upon my injuries, and thus terminated resuscitative efforts. My family, with the benefit of what I left for them in terms of my estate, continues to educate themselves and find productive lives.

All of these scenarios are potential outcomes for your patient. Your job is to decide which of these scenarios is statistically the most likely, and to make a humane decision when resuscitating. It ain't easy, my brother.

To oded (and all): Have a good holiday season. People who take care of people are special people. I hope that peace and prosperity finds you from now to eternity.

DB

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Head Injury - Termination of Resuscitative Efforts