Advance Medical Directive Hits the Spot

By Dr. Samuel D. Caughron, MD – Charlottesville Wellness Center Family Practice MDVIP

Sometimes you just hit the right thing at the right time. My focus in medicine has been to help people reach their goals. X was a wonderful 82-year-old male with multiple medical problems that I followed regularly. He lived with his son and daughter-in-law who were attentive to his needs. He came into my office with his daughter for his yearly exam. Although we had attempted to address his advance directive before, he deferred by stating, “Whatever my family wants.” This time, with his daughter in the office, he was willing to address the big issues and indicated his son as his decision maker, and, after discussion, marked his desires on the form from Sentara Martha Jefferson hospital. This was witnessed by his daughter and a member of my office staff. Little did we know how quickly we would need to put this into practice. We entered his directive into the US Living Will Registry and sent a copy to Sentara Martha Jefferson.

Four days later, he began to have a fever and cough and a temperature of 101. He was taken to the emergency room at Sentara Martha Jefferson where he was admitted with a positive COVID test. Over the next month, he gradually deteriorated, eventually requiring a respirator and died a month after admission. During the final stages of his illness, his advance directive was used to deal with multiple family members since it clearly indicated who was responsible for making his decisions and how aggressive he wanted his medical care to be.

In the best of circumstances these issues are difficult. What a blessing for him and his family that we were able to do this in such a timely manner. I am always amazed at how often seemingly random timing occurs. Like him, not everyone I see will complete the Advance Medical Directive during a visit, often wanting to put it off “a little longer,” but just a little bit of attention during that visit allowed this gentleman and his daughter to “seize the day” and make it happen.

Although everyone was sad that he died, they were consoled that his wishes were honored. We should all be so lucky.