A Parent in a Coma

A mother lapsed into a coma three weeks ago. Her doctors don't know exactly why. She is immediately put on a respirator to help her breathe. Her family, friends, doctors and nurses wait for any positive signs of a change in the patient. Meanwhile all of her vital signs are kept stable. The mother is given nutrients through an IV because she cannot eat or drink anything. Not much more can be done for the patient, until she wakes up from the coma.

Two weeks into the coma, the mother opens her eyes. Family and friends get excited thinking she is coming out of the coma. It is not the case. Her eyes wander and look like they are trying to focus, but the doctors don't yet know if they are focusing for sure.

Family and friends visit for 10 minutes every hour, since that is the rules in the Intensive Care Unit - ICU in the hospital. During the family's continuous visits, they sit and stare at the lying patient waiting for that positive change, or try to elicit a response from the patient. "Mom, squeeze my hand." The patient's eyes wander towards the direction the voice came from, but there isn't any hand movement as an attempt to squeeze a hand. Once again, the doctors, nurses and family members don't know if the eye movement in the right direction happened by chance, or if the comatose patient really heard the voice. They all wait for more changes, hoping for a positive sign.

On the third week, a tracheotomy needs to be done to relieve some of the pressure caused by the respirator. It all doesn't look good to family and friends, but they continue to hope.

Day after day the family members have plenty of time to think and struggle with their own questions regarding their current situation. The questions add up:

* How much brain activity does she have?
* What are the chances she will come out of the coma?
* How long do we wait?
* Which medical interventions to we approve of and which, if any, do we disapprove of?
* Do we sign a 'Do Not Resuscitate?'

Doctors say the mother's brain activity is minimal. One doctor tells family members to wait longer to see if the patient wakes up from the coma. Of course no one knows exactly how long the mother can remain in a coma. Stories from family members, friends, acquaintances, and read about in books mention different outcomes - 1 week, 1 month, 6 weeks, 3 months, 6 months, 1 year, 29 years.... There's a very slight chance she may wake up and can be rehabilitated. But do what extent can the rehabilation bring the mother as close to 'normal' as possible? No one knows until the patient wakes up.

Family and friends continue to wait for a change - any positive change. It's very difficult to continue on with the rest of their lives, even when they are home in-between visiting hours because they are so engrossed and consumed by their current, gloomy medical situation. Days that seems so long continue to pass one by one. Their intense thinking and questions continue:

* What determines a person's 'quality of life?'
* At what point do we give up hope and consent to hospice - no food or drinks and morphine given to keep the mother comfortable until she dies?
* Should we get the opinions of other doctors?

For every family the answers to all of the questions are different. For those who are religious, they believe when God says it's over it's over and continue to approve of every medical intervention until that time. A patient's heart is the last to stop and when that happens, God says it's over. Others need to hear that 0% brain activity means there isn't any hope for the patient and they stop all other medical interventions. Some family members donate the patient's organs in such cases. Many people continue to have hope with some brain activity, even if it's just minimal and continue all medical interventions and care. Some think of the quality of life with minimal brain activity and decide to let the patient 'go.' Few people don't believe in any medical intervention and let the patient's body run its course, until the patient dies naturally.

Again I say that for every family the decision may be different. When my mother was terminally ill with Parkinson's Disease, I carried on her wishes until her last breath. She was very religious and believed that when God says it's over it's over, so I agreed to a feeding tube and all other medical interventions and care until her heart stopped. By doing so, I wasn't left with any guilt after she died. I recommend you make decisions which will not leave you with any guilt afterwards either. Do the best you can for your parent(s). Always remember it's not about you, it's about them and their wishes. Afterwards you will feel content that you did all you possibly could for them.