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It started with shortness of breath and ended with a full-out major medical press, sadly unsuccessful. Please make allowances for me, as I was not always at the sessions where the doctors explained what was happening, so have received much of the information at least third-hand, and through a cloud of pain and emotion.

I started this post on December 18th but had to put it aside to gain some perspective.

See you after the orange thingie...

Last night my younger brother died. He was only 54, happily married with 4 wonderful thoughtful children, each of them just testing the waters of adulthood. Until Halloween he only had one health problem, sleep apnea which he has been treating for years with a breathing mask he wears overnight to make sure he keeps breathing.

He has been overweight to some extent for much of his adult life but recently had taken up running with his wife and was losing weight. In September he came down with something his family called the flu but as it involved vomiting probably wasn't. He felt generally unwell for some time afterward and then on October 31st he had trouble breathing so his wife took him to the emergency room.

He was diagnosed with pneumonia, possibly (they thought) caused by inhaling some vomit and was given oxygen and IV antibiotics. He left the hospital nearly a week later, having to return twice a day for antibiotic treatment. About a week later, he had such difficulty breathing he was taken back to hospital by ambulance. They did a lot of tests including an echocardiogram which I assume was inconclusive as they arranged to send him by ambulance to a major hospital for a trans-esophageal echocardiogram.

As a result of being so unwell for so long he had totally lost his appetite and had not eaten for some time, so when the test showed significant circulatory impairment (his heart was working hard but the blood wasn't going anywhere) they were able to take him directly into surgery to install a mechanical valve in his left heart. The surgeon also found a large sac of pus attached to the outside wall of the heart which was eating into the heart muscle and was able to remove it. Fortunately,probably due to the IV antibiotics, the bacteria in the pus was inactive. (The surgeon indicated this whole episode could have been caused by recent dental work, just a cleaning.)

After the surgery they sewed him up and attempted to restart his heart and lungs. The heart started quickly but his lungs were what the surgeon called "wet" and were not able to supply the oxygen his body and heart needed, so they opened his chest again and reinstalled the heart-lung machine that kept him alive during the surgery. They hooked up another machine that performed dialysis to suplement/replace his kidneys.  He was taken to the cardiac intensive care ward where his body was cooled to preserve his brain (I thinK), extra liquid (close to 24 litres - roughly 24 quarts) was pumped into him to help the machines work and he was put into a medically induced coma to allow him time to heal.

That was his situation when I saw him the first time, colder than he should have been, lying with his chest still open, more tubes and machines than I ever imagined could be coming and going from one person. The most eerie part of this was that he wasn't breathing, he was just lying there.

The staff in that intensive care ward were amazing, there were respiratory technologists, profusion technologists, physical therapists, nurses, doctors and others working around the clock to keep him alive for over two weeks. His surgeon (we were told he was the second best heart surgeon in the country) came to check on him regularly and family conferences with the medical staff were arranged at every juncture. During that time there was crisis after crisis, followed usually with some key indicator improving giving hope, only to dash it with the next crisis. They allowed family to visit him, two at a time even when the intensive care ward was technically closed to visitors. They were all extremely competent and caring, we could not have asked for better care.

The hospital provided a private waiting room for the family to use just down the hall from intensive care and a lovely volunteer lady came by often to offer tea, coffee, ice-water and support. Friends and family stopped by regularly; according to my sister-in-law, one day there were 43 visitors. She and her 4 children put their lives completely on hold and camped out in that waiting room for nearly a month. A good friend offered them an apartment just 15 minutes away saving them long commutes between home and hospital.Towards the end the doctors suggested they might want to stay at the hospital overnight, however in a conference the next day had some rather hopeful news; his liver and kidneys were starting to improve (I am not sure at what point we had been told they were failing) and they decided they needed to take him off the heart lung machine. They said if his lungs were still not working they would put him on a different, lung only machine.

We found out later that they had called in a representative of the transplant team at a city hospital to assess him for a heart/lung transplant. Unfortunately they found his other organs had been too badly damaged by the length of time he was receiving poor blood flow.

A few days after switching machines it turned out it wasn't enought and he died.

My brother's family and most of their friends and relatives (except me) are very religious and prayers and exhortations to pray had been flying thick and fast the whole time. My brother and his wife were missionaries in Pakistan for over 10 years, as were a number of our aunts and uncles - in many different countries. I felt really sorry that they believe in a god who would purposefully take away a good man like this just when his children were nearly grown and he had the prospect of grandchildren and a happy old age.

But I digress. I am not writing this to discuss the false hopes religion instills and encourages, I am writing to say that other than the income my brother, sister-in-law and their children lost during this ordeal, they are not bankrupt. The care my brother received was surely worth many hundreds of thousands of dollars, more likely upwards of a million dollars, but it was provided as a government service. We are Canadian.

It is my understanding that unless they had the most amazing health insurance, it is likely they would now be bankrupt. The fact is that my brother and his wife were self-employed and could never have afforded a gold plated health insurance policy.

The Canadian medical system is not without its problems, but when you get sick, you get the best care available whether you are rich or poor, without a worry about the cost, not even a copay. Each member of the hospital staff and all the doctors really care about each and every patient and their families and it shows. This is what MEDICARE FOR ALL looks like, and I want the Daily Kos family to know it is worth fighting for. Don't give up!

Originally posted to PatMcD on Wed Feb 06, 2013 at 12:56 PM PST.

Also republished by Community Spotlight.

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