Chronic Critical Illness

Early in my intern year, I admitted an 80-year-old man with pneumonia to the intensive care unit (ICU). He had hypotension and was struggling to breathe, and my senior resident and I told his family that it was touch and go. Their response: Do everything. He had repaired cars for a living, and he was a tough guy, a fighter.Ten days later, his condition had stabilized, but he was delirious and unable to breathe on his own. We told his family that if we were to continue, he'd need a tracheotomy and feeding tube. They agreed without question. We . . .