I Don’t Want CPR

I’ve addressed this issue at least twice in the last twenty years. The first time was when my physician colleague, Dr. Hemlock, asked me to join her in reviewing studies of CPR outcomes. It was back in 2005, I think. Dr. Hemlock was the senior physician over the State Living Centers for people with developmental and cognitive disabilities. I was the senior physician over the State’s program for quality improvement in Long-term care facilities.

What we found and reported to our state agency was that CPR was, most often, a futile intervention in folks who were either elderly or chronically ill. The percentage of folks who survived CPR and left the hospital was in single digits in most studies. Among octogenarians, the survival rate was around 1%. As many as half of those who survived CPR at any age experienced noticeable neurological injuries. Alas, this wasn’t the picture that TV shows portrayed or that the public at large expected.

A couple of years ago, I experienced a small-vessel, sub-cortical stroke. My ER physician recommended an IV medicine that would dissolve the clot that had caused my stroke and hopefully limit the severity of the stroke’s damage. However, the treatment held some small but real possibility of brain hemorrhage. I agreed to the treatment noting that if I experienced such a hemorrhage and had a subsequent cardio-pulmonary arrest, I did not want CPR. Susan was present. “We’ve had this conversation multiple times in the past ten years,” I told the doctor. “You do exactly what she says to do. I have an advanced directive at home,” I said. I got my IV medicine in the ICU. I didn’t have a brain bleed, and I went home – bullet dodged. Later, I posted on FB regarding that experience.

So here I am this evening, again addressing the issue. This time it is because of an article that I just read in The New Yorker. I invite you to read it and share it with your significant other and close family members who may someday find themselves cast as your surrogate healthcare decision makers. If you don’t have a POLST or Advanced Directive, consider making one that complies with your state’s laws regarding CPR and other advanced life supports.

I invite you to read the article from The New Yorker here – The Hidden Harms of CPR.