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About Us > Charlotte S. Yeh, MD

“So, I did the unthinkable….I let the husband and father go on his own, and not get in his way.”

~Charlotte S. Yeh, MD

Charlotte S. Yeh, MD

Advisor to The Conversation Project

One of my most moving experiences as an emergency physician was caring for a patient I did not save.  It was a typical frenetic harried day in the ED, with the range of encounters of various broken/sprained limbs, fevers, chest pains, cuts, and falls…. But on this day, the ambulance rolled up to the doors, bringing in an older gentleman who had arrested (heart stopped) at home.   His wife had found her husband at home unresponsive, and started CPR immediately without thinking twice.  For those of us who care for many sudden death victims, it is always exhilarating and heartwarming to see someone get the best chance possible to survive with bystander CPR.  So, her husband rolled in through the doors, unconscious and intubated, with an initially viable heart rhythm.  As I started more aggressive stabilization measures, the wife, anxious and stressed, showed me a multiple-page completed advance directive, clearly indicating her husband did not want heroic medical measures if his heart stopped and he did not revive.  Through her tears, she explained that her husband and she had talked through this formal decision together 5 days earlier, even though he had no terminal condition.  Almost apologetic, she turned to me, with early signs of guilt to ask “Should I have not done CPR?  I just didn’t think, and tried to save him.  He doesn’t want to be on life support.  What do you think we should do?”

I truly hope the Conversation Project will succeed, so that across the country, we doctors and nurses, clinicians will know that we can and will do the respectful and right thing in death as we so easily do in life.  That is truly what Patient-centeredness, and Patient partnership really means.

And I paused…First, as I told the wife, “ Of course you did the right thing.  Unless you tried you would have no idea if doing CPR might have saved him back to the husband you know.”   And then I did the unthinkable…. especially in an academic emergency department where we are trained and expected to everything we can to save a life.   Her husband’s vital signs were starting to deteriorate.  I turned to the wife, and asked, “Knowing what you and your husband discussed, what do you want me to do?  I can definitely do ‘everything’ and possibly save him with defibrillation shocks, drugs, monitors, studies, and more, and he might have a chance to come back.  Or we can see what he can do on his own, and we can support him, knowing what a complete document and deep conversation you have had with your husband.”  She looked at me, with renewed confidence, and said, knowing what she knew her husband wanted, could we just provide enough support for her 5 children to come by the emergency department to say good-bye.  Of course, I would.  We didn’t try to defibrillate, but assured he was comfortable, with his erratic heart rate and blood pressure, while her children arrived one by one and gathered at his bedside in the major resuscitation room.  For 2 hours, they talked to him, held his hand, held their own hands together, and were with him as he peacefully ebbed away, knowing they had followed his wishes, yet had the time to have peace with him.  The ED staff were angry, and upset with me…how could I not do everything?  How could I tie up a resuscitation room, in case another critical patient rolled through the door.   And yet, at the end, even the most hostile of the staff turned their feelings around…. They saw the love from the family; they saw the quiet comfort afforded to their husband/father; they saw the acceptance with peace, even with the sorrow… and realized, wasn’t this what any of us would want for our loved one?  They heard the thanks, the intense gratitude from the family to us, for allowing her husband to be afforded the dignity in life and in death that he had so carefully shared with his family, and with  the papers to prove it.  Wasn’t this one of the most noble uses of the “resuscitation” room? And as suddenly for the staff as when he arrived, as the family slowly left, there was an overwhelming feeling of spirituality and grace that filled the ED, its patients and its staff, that made us all better partners of our patients in crisis that day.  So, I did the unthinkable….I let the husband and father go on his own, and not get in his way.  And I know his family will always remember the kindness and respect we showed.

I truly hope the Conversation Project will succeed, so that across the country, we doctors and nurses, clinicians will know that we can and will do the respectful and right thing in death as we so easily do in life.  That is truly what Patient-centeredness, and Patient partnership really means.

 

Dr. Charlotte Yeh is the Chief Medical Officer for AARP Services, Inc., the wholly-owned taxable subsidiary of AARP. AARP Services, Inc. manages the carrier relationships for and performs quality control oversight of the wide range of products and services that carry the AARP name and are made available by independent carriers as benefits to AARP’s almost 40 million members. On April 11, 2011 Dr. Yeh was the recipient of The American Hospital Association 2011 Board of Trustees Award, she was the recipient of the 2010 Outstanding 50 Asian Americans in Business Award. Dr. Yeh received a bachelor’s degree from Northwestern University in Evanston, Illinois and her medical degree from Northwestern University Medical School in Chicago.