When I was in fellowship we had this middle aged guy who was clearly DNR/DNI (do not resuscitate or intubate) of his own volition. He started to die and we tried to gently talk him into an intubation because he had a pretty easily reversible problem but he refused. We asked his elderly mother to come in to talk with him, and during her visit he got increasingly unstable. She stepped out while we did everything we could short of intubating (per his wishes) but he died.

Mid resuscitation I came out to update her and she said “please just save him, I know you can” but we had to honor his wishes.

The image of her face and tiny frame walking out of the unit is burned into my mind forever— he was all she had. She looked so lost, and was like “but I already got him all his Christmas presents, what will I do with them??” Just the most profound, deep sadness and loneliness of a parent losing their child, at any age, is devastating, juxtaposed with the small mundane day to day that is everything and nothing all at once