It’s Monday again, and I’m sitting here pondering a discussion I got into yesterday after a nursing friend shared a viral meme about cardiopulmonary resuscitation (CPR). Right now, people are talking about CPR. Professional football player, Damar Hamlin, collapsed on the field and received CPR, which saved his life. I don’t watch football, so even if I had been in the United States when it happened, I probably would not have seen it happen live. But a number of people on my friends list saw it.

Damar Hamlin is reportedly now doing much better. He will have to recover from this incident, but as a young athlete, he’ll probably be fine. However, as one nurse pointed out, CPR doesn’t always end well for every patient. She made a meme, and it went viral.

I saw this meme because one of my nursing friends shared it. It made me remember a blog post I wrote in 2013. Back then, it was in the news that an 87 year old woman, who lived at an independent living facility in Bakersfield, California, had collapsed. No one rendered CPR to her. Instead, a supposed nurse at the facility called 911. The nurse explained to the 911 dispatcher that it was against the facility’s policy for employees to perform CPR on residents. A lot of people seemed shocked that this was a policy at a place where it seemed like there would be emergency medical assistance available for residents.

The dispatcher, upset that the “nurse” wasn’t acting, reportedly pleaded:

“Anybody there can do CPR. Give them the phone please. I understand if your facility is not willing to do that. Give the phone to that passerby,” the dispatcher said. “This woman is not breathing enough. She is going to die if we don’t get this started.”

But the nurse refused to render aid, and followed the protocol set by her employer. An ambulance arrived a few minutes later, but the woman died at the hospital.

It outraged a lot of readers that the nurse simply let this 87 year old woman die without a fight. Many people posted that the woman’s family should sue. Some felt the “nurse” should be fired and lose her nursing license. Some seemed to think police should arrest the “nurse”.

Inspired by some of the more vitriolic comments, I decided to blog about the situation. In that post, I wrote:

As someone who has studied public health and social work, and lived abroad several times, I was amused and amazed by the comments that came with that article.  There’s quite cultural statement made about this situation.  Look at it.  The woman was 87 years old.  That’s an impressive life span.  CPR is a very traumatic thing to do to another person.  Even if you’re young, CPR can cause cracked or broken ribs, a broken sternum, and internal bleeding.  At 87 years old, I would imagine this woman was a lot more fragile than your average adult is.  Moreover, CPR done to elderly patients doesn’t actually have an impressive success rate.  It’s an emergency intervention and doesn’t usually turn out the way it does on TV shows like ER.

CPR done correctly might have saved her… just in time for her to spend days or weeks in the hospital, hooked up to machines and running up big medical bills that perhaps she had no means to pay.  At age 87, she was likely on Medicare.  She might have made a full recovery… or she might have suffered brain damage, because the CPR wasn’t done correctly and she went without oxygen for too long. She might have lapsed into a coma, where doctors and relatives would have to decide when the appropriate time to let her go would be.  But here in America, we are taught from a young age that we should spare no expense to save a life, even a life that has been well lived and is about finished.  You are seen as a criminal if you opt for death.

I remember posting about the case on my Facebook page. At the time, I had a lot more “friends”, and some of them were argumentative types. The thread about this case got heated, fueling the post even more. I continued:

…there are many places around the world where no one would have raised an eyebrow at what happened to this lady.  In many places around the world, family members or neighbors care for the elderly.  And when death comes, it’s not always seen as something that has to be fought.  Death is a part of life, and it will happen to everyone at some point.

While I can see why it’s distressing to think of a person just watching someone die while on the phone with 911, I can also understand why that assisted living facility has the policy they have.  You can bet it has a lot to do with litigation and insurance. 

It’s hard to think of sitting on your hands in a situation like this.  It is a little unnerving to think about when a person’s life is no longer worth saving due to advanced age.  But I think in this case, it’s likely that this woman had a better death than she might have.  I wish we could come to some kind of consensus as to how we can let people die with dignity.  We can’t have everyone living until they’re 100, though.  The system can’t and won’t support it. 

So… there I was yesterday, looking at that viral meme, and remembering that 2013 case. When I looked at the comments on the original thread, I found out people still seem to think CPR is always justified, no matter what. The person who originally shared the meme is apparently a nurse, and she’s run many codes on people. A lot of the codes she’s run have been on people who are clearly at the end of their lives. They either didn’t have a “do not resuscitate” order or a living will, or their distraught family members feel compelled to keep them alive at all costs. Family members don’t always realize what goes into a “code”, and how violent and aggressive it can be.

Some commenters were profane in their responses, “bravely” stating that they don’t care about broken ribs if it means another day with a loved one. It’s easy to say that when you’re not in severe pain, or dealing with chronic health issues that make life torture. The fact is, everyone dies. And in every life, there will come an opportunity to make an exit. Sometimes, when a very elderly person collapses, it’s simply their time to go.

Later that day in March 2013, I wrote more about the case. I identified the woman who collapsed. Her name was Lorraine Bayless. She lived at an independent living facility, as opposed to a nursing home or even an assisted living facility. The stories referred to the woman who called 911 as a nurse, but it wasn’t clear if she actually was a nurse. It wasn’t clear if she’d had a DNR, either. Some sources reported that she didn’t have a DNR, but at least one other reported that she did. Experts at the time were talking about how “morally wrong” it was not to render aid to Ms. Bayless. But other people in the know were discussing what happens to a person when they get CPR.

I’m 50 years old, and I live with aches and discomfort every day. I’m not in terrible pain yet. A lot of what ails me is helped with over the counter pain medications, or even a glass or two of wine. Unfortunately, as people age, they tend to hurt more. They become more fragile, and develop health conditions that make it more difficult to recover from illnesses and injuries. And, it’s always sad to bring this up, but healthcare is very expensive, especially in the United States. A very elderly person who is nearing the natural end of their life will run up huge bills, even if they survive another day or two.

As many of my healthcare friends pointed out, it’s uncommon for very elderly people to fully recover from CPR interventions. I’m not saying it never happens, but that it’s rare. And that kind of intervention, which almost always involves broken ribs and severe bruising, will mean significant pain in addition to whatever the condition was that caused the collapse in the first place. The whole point of the viral meme I read yesterday was that people often suffer when they get CPR, along with the suggestion that people talk to their loved ones about what they would like to have done to them if they collapse. One would also hope that they put their wishes in writing, so that medical personnel can honor their wishes without risking their careers or their freedom.

On another note…

One thing I noticed and want to comment about is another one of my “pet peeves”. So many people seemed to be deliberately obtuse about the meme’s message. It was as if people thought the nurse was saying that CPR is never justified. That’s not what she was conveying. She was saying that CPR is brutal to bodies. Some people won’t recover from the physical or mental trauma of the violence and aggression of CPR. People should consider that reality before demanding that medical staff resuscitate their very elderly and frail loved ones who suffer from chronic illnesses.

And also… I wish to God that people would read things before commenting. So many people mentioned cracked ribs and other injuries that come from CPR. I think it’s inconsiderate to post comments without reading the post in question or other people’s comments. Why should I read what someone writes when they haven’t taken the time to read what others have written?

In essence, people who comment before reading are telling everyone that their comments are more important than other people’s comments are. That is quite an arrogant and self-centered statement, in my opinion. Reading before commenting saves time in the long run, because you might find that your comment is unnecessary or, perhaps, inapplicable to the situation. I know that making this statement might make me look “mean” or “rude”, but honestly, I think it’s rude to waste people’s time by making statements that are irrelevant or have already been made umpteen times. Just my opinion.

Anyway…

I hope you have a good Monday. I’ll be watching for new inspirations, as I continue to read my latest book. See you tomorrow.