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This is the subject of Connelly’s recent book, The Journey’s End: An Investigation of Death & Dying in America. It’s going into an intensive care unit and getting feeding tubes and ventilators and all this stuff that isn’t going to change anything. But they don’t always understand what that means.
Because, if anybody hasn’t seen it, you’ve got a great Twitter feed that gives tons of pearls on palliative care and a lot on communication. Speaking of pearls, should we move to Shunichi’s Twitter feed? Alex: Shunichi, your Twitter feed is like haiku. What motivated you to dive into this? Don’t use that.
And Lauren Ferrante has found in a study published in JAMA Internal Medicine that trajectories of disability in the year prior to ICU admission were highly predictive of disability post-ICU, on the same order of magnitude as mechanical ventilation. He, his Twitter feed though is brilliant. Eric: Yeah. Alex: Yeah. Lauren: Shock.
However if you want to take a deeper dive, check out his website “ The Ink Vessel ” or his amazing twitter feed which has a lot of his work in it. And yet, when the reality of breathing difficulties, BIPAP, the talks of tracheostomy and ventilators set in, what had seemed so clear on that piece of paper, no longer seemed so clear.
You’ve written in a lot of places, including your own books. I think one of the residents you asked how would they broach a subject, and he said wording like, “Unfortunately, he still needs a ventilator.” Alex: A feeding tube. Eric: The Hidden Harms of CPR. Sunita: There we go. I know, man, I just screwed up.
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