Tami deserves recognition for how she took care of our father and husband and how she interacted with us. Tami exhibited a unique combination of professionalism and compassion. This is coming from an engineer who is not easily impressed. When Dad suffered the cardiac arrest and was rushed to the emergency room, one of our concerns was that he would not receive the same level of care as a much younger person. After all, he was 90 and had lived a long life. But, a number doesn't always tell the entire story of a person's life. So, with this as part of our thought process, we expressed to the NPMC ER staff to do what was necessary to give him the best "shot" at recovery possible. This was before we had received any real prognosis on Dad's condition.
So, once Dad was stabilized and a couple of scans including a brain CT were performed, the ER staff discussed next steps with us. A relatively new treatment called therapeutic hypothermia was suggested as an option. It was explained as a process that included cooling the body to prevent/reduce brain damage. I (we) don't remember the time frame being discussed, but based on our research this process should take approximately 24 hours. We were informed that the equipment wasn't available at NPMC, and Dad would have to be transferred to CHI St. Vincent. We agreed that this was the best plan of action.
It took some time for NPMC to transfer Dad to CHI. He was admitted to CHI ER around 2:00 am. Upon arrival at CHI, he spent some time in the ER before being transferred to the ICU. When Dad finally arrived in the ICU, we met a nurse. She told us she had been anticipating Dad's arrival for some time and had been patiently waiting so she could begin the cooling process. She allowed us to spend a few minutes with Dad, and then politely asked that we step out while they prepared him.
I went home and got about an hour of sleep, and returned to the ICU about the time of shift change. The night nurse was bringing the day nurse up to speed on Dad's condition and status of the cooling process. Later that morning the doctor stopped by during round. The doctor told us that at the end of the process, once his body temp was raised back to normal, a brain MRI would be performed. We were anticipating that the MRI would be performed sometime early Thursday morning, and we would be able to make a decision shortly thereafter.
As we returned to visit Dad the rest of that morning and throughout the day, we noticed his wrists had been restrained. The nurse explained that Dad had begun "posting" and that he was also beginning to experience facial twitches. Neither of these were positive signs and could indicate neurological damage. While visiting with the nurse we learned that the process that we originally understood would take 24-hours was going to take at least 4 days! 24 hours cool down, 24-hour maintenance temp, and 24-48 hours to warm up before the MRI could be done. This was a complete surprise to us. It was at this point we realized that things were being done that we didn't fully understand. I believe this became apparent to Tami as well. No one had sat down with us as a family to explain exactly what was happening and why, i.e. treatment options, timing, potential outcomes, etc. at least not in a way we understood. So after a brief family meeting, we approached Tami with our concerns and asked her to arrange a meeting with Dad's entire medical team. She immediately reached out to the doctor and other members of Dad's team. In a relatively short time frame, a meeting for the next morning had been arranged.
That evening I happened to be present near the end of shift change. I was visiting with the nurse and thanking her for all her help and advice. I noticed the first night nurse was leaving so I called her to come over. I had something I wanted to tell both of them together. That something was I wanted them to know how much we appreciated HOW they took care of Dad. I told them that. "Both of you give nurses and the nursing profession a good name."
The next morning we met with the doctor, Dad's PCP, Tami and other members of Dad's team. The doctor explained that the probability of dad recovering and having a normal life was very low. This was the moment of clarity we had been seeking. It became very clear that the extreme measures being implemented to help Dad had very little chance of success and that Dad had lived his last days. As difficult as that was to accept, I felt at peace. I knew that we had done the very best we could do for Dad, that we had given him a "shot" at recovery. But, I also knew he would not have wanted us to continue down this path. I (we) knew it was time to stop and let Dad go. The decision wasn't that difficult because Dad had already made it for us. With the decision made, Tami proceeded to prepare Dad so he would be presentable while we spent what was most likely going to be his final moments with him. After disconnecting Dad from the machines and removing his breathing tube, Tami hurried to the waiting area to get us. I saw her come around the corner and immediately began walking towards her. She said Dad hadn't taken a breath since removing the breathing tube. We rushed to his room and gathered around him. She remained with us. Dad never took a breath or regained consciousness. His vital signs slowly faded until he was no longer with us. We were fortunate to be able to spend his final moments with him knowing that we had made the right decision for him and us.
Had Tami not been straightforward with us about what the process actually entailed and then took charge of arranging the meeting with Dad's team, Dad would have spent several more days "hooked up to machines" before we really understood what was happening. It was because of her compassion, her patience, her pragmatic responses to some very difficult questions, and her leadership in arranging a meeting with Dad's medical team, that we were able to receive the essential information that allowed us to make a very emotional but necessary decision with confidence. We remain confident and at peace that we made the correct decision and did right by Dad. I haven't lost a single night's sleep over that decision. And for this I (we) have Tami to thank.