Staying in the Room.

The call from the nursing home relayed that an 85-yearold male was coming in by ambulance complaining of increased shortness of breath. The nursing home told us that he had an unknown code status. Once the patient arrived, it was clear that he was in the process of dying. While I was preparing for aggressive resuscitative efforts, my attending physician was shuffling through some paperwork that came with the patient and discovered a “do not resuscitate” order, signed by the patient. The paperwork also stated that he had advanced cancer. It was clear why the patient had previously decided he did not want any procedures to be done, which we were quickly prepping to perform. With this added information we put a stop to our efforts, followed the wishes of the patient, and made him as comfortable as possible in his final moments. My attending asked the paramedics if the patient’s family was coming, and they said they would be arriving in 5-10 minutes. At the time, I was the senior resident in charge, and I was feeling the increased pressure of wanting to see more patients and to get some charting done. A 5-10 minute wait may not seem like much, but in the shift of an emergency physician, it can feel like an eternity. However, my attending didn’t leave the patient’s side, and he held his hand the whole time. After several long minutes, our patient’s family arrived in the emergency department. We went over the care of the patient and the family quickly understood the entire situation. With tears in their eyes, they still had one request from us: they asked that my attending and I participate with their family in prayer. Of course, we could not refuse. So as we gathered around the bedside, all holding hands, we instantly felt for that brief moment as members of the family. The more we listened to the prayer, something incredible happened. The patient, whom we had no previous connection to and Lakeland Health Emergency Medicine Residency, Department of Emergency Medicine, St Joseph, Michigan