A little over two years ago, my elderly mother was admitted to the hospital. Almost 90, she’d been short of breath for days — uncomfortable, perspiring, unable to sleep properly.
Blood tests, a chest X-ray, and an echocardiogram followed, whereupon her doctor pronounced: “You have congestive heart failure, Mrs. Les.”
I arrived on the scene the next morning to find her lying in bed, iPad open to Dr. Google, earnestly exploring the gravity of her diagnosis. Her actual doctor her was nowhere to be seen.
Mom looked up at me, her lined face etched with worry, blinking rapidly as she held back tears: “It’s serious, Ed. My heart is failing.”
Her concern was understandable. She ‘d been told that her heart her — the very engine of human vitality — was failing. And failing seems next door to stopping. And when your heart stops, you’re dead — Mom didn’t need Dr. Google to grasp that concept.
Her heart was old, undeniably. The elasticity and vigor of cardiac youth had long since departed; the muscular pump was weary, its inner chambers enlarged, its valves leaky.
But it had plenty of life left to give — it just needed some help.
Her doctor prescribed diuretics, along with a medication to give her heart muscle a much-needed boost. A few days later, vastly improved, she was discharged home. She was OK — but in her view her, she ‘d come within a whisper of death.
I flew home, mulling over the diagnostic language used by doctors to talk to patients like her. Why do we talk of “failure” when we’re referring to something that’s simply in need of assistance? Don’t we realize the negative connotations our “failure” terminology carries for patients? Do we not appreciate the unnecessary fear and anxiety that creates? Why not label her condition “congestive heart syndrome” and lose the defeatist, unhelpful “failure” terminology?
After landing in Calgary, I climbed into my 16-year-old Acura in the airport parking lot. Despite the deep November chill, the engine turned over immediately, and I headed home, adding more kilometers to the 400,000 clicks I’d already logged in that vehicle.
Car years are a bit like dog years: multiplying by seven gets you a rough approximation of human age. By that metric, my Acura was 102 — and it showed. The exterior paint was dull and flecked with rust, the leather interior cracked and peeling; the smooth purr of the engine had given way to a phlegmatic growl, and it drank oil so greedily I no longer had to worry about oil changes — the oil changed itself; and the engine light had been on for more than a year, thanks to the catalytic converter packing it in.
But the car kept on running and running, with the occasional assist from my mechanic. He never prattled on about “car failure,” by the way — he simply patched up the old beater when needed and sent it back out on the road. I saw no reason to part with it; it did what I needed it to do — it got me from point A to point B. And new cars cost money. (My Dutch roots run deep; as the old joke goes, copper wire was invented by two Dutchmen fighting over a penny.)
It didn’t last forever, of course. Mechanical problems continued to accumulate along with the repair bills. I finally gave up, donated it to the Kidney Foundation, and replaced it with a younger version.
On the other hand, my mom is still going strong, more than two years after being tagged with that diagnosis of “failure.” I’m flying this weekend to help her celebrate her 92nd birthday her.
For sure, her age is showing. Her catalytic converter her may be dead, she’s leaking oil, and she sees her her “mechanic” more often than she’d like. But overall, she’s running just fine. She’s not “failing”— she’s living.
And no matter what happens, we won’t be donating her to the Kidney Foundation.
J. Edward Les is a pediatric emergency physician.
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