Closure.org Blog

By Jonathan Weinkle, MD

Joe Klein has spent most of his adult life on the presidential campaign trail, reporting for Time magazine on presidential politics.  He asks hard questions and provides sharp analysis of both Democratic and Republican candidates.  One wonders if, in 2012, he will have a new, difficult question to ask, born of his recent personal experiences.

Klein’s parents recently died, each of them after the long series of illnesses that typifies how older Americans die in this day and age.  His mother succumbed to pneumonia in the end, and his father to kidney failure.  In a recently published Time cover story and accompanying video, he discusses the experience.

Nothing Klein says will be news to anyone who has recently experienced the death of an older loved one.  Procedures were done, like repeated lab draws and placement of a feeding tube, that did not add length of life, but did add to the burden of suffering.  The feeding tube was placed because when the doctor in Pennsylvania called Klein in Chuck Grassley’s kitchen in Iowa and said, “We have to put in a feeding tube or we’ll lose her,” he felt like he didn’t really have a choice at that time.  The whole truth of how soon Mrs. Klein was likely to die didn’t come out until after the time was already in.

By Jonathan Weinkle, MD

A response to a news item about Dan Chen’s Last Moment Robot

So long as it doesn’t drown you in food that you cannot taste and your body can’t use

By Jonathan Weinkle, MD

Every doctor and nurse knows what the vital signs are. There are four of them: pulse, respiratory rate, temperature and blood pressure. They are called vital, meaning crucial. Meaning alive. Meaning essential – both to the patient, who cannot live without them, and to the medical system, which cannot function without them.

More recently a fifth vital sign has been added: oxygen saturation. Surely to a creature that breathes air in order to live this is crucial, too. So there are five vital signs, five numbers that we must know about everyone in order to know anything about them at all.

That is, until they are dying.  When vitality is about to be extinguished, how vital are the vital signs? How necessary, how crucial, is it to awaken the old man from a peaceful sleep to discover these formerly all-important pieces of information?  When all have understood that death is approaching? After all, if we find the vital signs are abnormal, that there is a fever, or elevated blood pressure, or slow breathing, what will we do?  Will these bits of data tell us anything other than what we already know – that the end is near?