Thursday 28th June 1990   Home Visit 13.09

“How am I doing?” Mrs Austin asked, optimistically.
Dr Lewis sat down after she had finished examining Mrs Austin. She reached out and took her hand.
“I think that things are reasonable. You are certainly no worse than last time I was here.”
Mrs Austin nodded: “I feel about the same.”
“Your heart is extremely weak, now.”
“That’s why I’m so breathless?”
“Yes, it makes you breathless and tired. Your blood pressure is very low and that causes the dizziness and unsteadiness. I am worried about you falling.”
“I’m managing.”
“Yes, you are managing quite well, considering.”
“Do you want me to carry on with the same tablets?”
“Actually, Mrs Austin, there is something else that I want to discuss with you.”
“Yes?”
“Well, when you are as poorly as this, there is a possibility that your heart will stop beating. You could have a cardiac arrest.”
“I suppose it happens to us all in the end.”
Dr Lewis paused. “I suppose it does, really. That’s what I wanted to ask you. If that does happen, if you do have a cardiac arrest, do you want to be resuscitated?”
“It would be my last chance?”
“It would be . . . but . . . your heart is so weak that I think resuscitation would be extremely unlikely to be successful. If we did manage to get your heart going, I suspect that exactly the same thing would happen again, very quickly.”
“How quickly?”
“To be completely honest, I don’t think that you would even have enough time for a cup of tea.”

“The alternative,” Dr Lewis said, “is to let nature take it’s course. If your heart stops beating, we don’t do anything. I think you would be quite comfortable.”
“There wouldn’t be any pain?”
“I don’t think so. It wouldn’t be a bad way to die.”
Dr Lewis and Mrs Austin looked at each other as they considered the situation.

“I don’t want you to make any decisions now, Mrs Austin. We can have another chat about it when I come and see you next time.”

I don’t think you would even have enough time for a cup of tea.
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