Lost Brother

Last week I was called to do a palliative care consult for a gentleman named Mr. Daniel Faraday (not real name) with End Stage COPD. I was to meet with the Brother, Michael Fraday, and the Niece (the patient didn’t have decision making capacity) to discuss the patients current condition and discuss the Goals of Care. Daniel had been intubated early in this hospitalization and the family was able to witness his “suffering” while on the ventilator. They didn’t want to put him through this again since it seemed that he was continuing to decline again and he was a full code (means that a “Code Blue” would be called to initiate full resuscitative measures…intubation, chest compressions, medications etc.). This situation was actually bitter sweet for Michael because Daniel had lost contact with Michael for the last 12 years. Daniel may have spent time being homeless and the circumstance surrounding this is unclear. Michael was found by the social worker only during this hospitalization and only during this hospitalization has he reconnected with Daniel. Although on the surface this appears to be unfortunate and sad, I thought about what would have happened had Michael not been found. Since Daniel is nearing End-of-Life he may have died without Michael finding him or knowing what happened to his brother. Michael himself would have continued to wonder about his brother for the rest of his life. So even though the information that was given to him was somber, Michael seemed to decide to make the best of whatever time he had left with his brother and this encounter and experience would provide closure in his life. I know that one never “closes” those memories after a loved one dies, but I think in this situation the closure is having found his brother and in turn finding the missing piece and completing the puzzle of life. Their story reminds me about how easy it is to take life and family for granted.