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The Right Stuff

The first man on the moon has died.

Old Glory

Neil Armstrong was the commander of the Apollo 11 mission, and he landed the lunar module Eagle on the surface of the moon.

Armstrong (astronaut, not bike-racer) will always be remembered as an American hero. According to the Wall Street Journal,

Mr. Armstrong died following complications resulting from cardiovascular procedures, his family said…It didn’t say where or when he died.

He’d undergone cardiac surgery about three weeks ago. Nothing novel about that in America–happens every day. But it was two days after his eighty-second birthday. Our medical wizardry has pushed the boundaries of what procedures are “appropriate” for people at older and older ages.

No knock against his care team–anyone would have wanted to help Armstrong live longer. I can’t help but wonder, though, if his family feels that way after watching him slowly succumb in the hospital over the subsequent weeks.

He deserved a dignified exit, away from all the whistles and bells of a cardiac intensive care unit. But he prided himself on technology and know-how. I hope the manner in which he died was in accord with his wishes.

2 Comments

  1. I think the idea of an 82 y.o. having cardiac surgery is not so rare…in the greater Boston area, generally the line is..well, you are a good candidate for the procedure, the risk of complications is low/minimal/manageable. what is NOT said is that the risk from other elements such as infection, anesthesia, medications used during your hospital stay, the noisy environment, development of delirium, etc. is not mentioned at all, and is minimized if the patient/family asks. The reality of going to a nursing home for rehab care before returning home with VNA care, the problems associated with care transitions, and the fact that the patient needs a family member who can be present AND advocate for patient in all the settings never comes up in a discussion with a cardiologist, either! The reality that recovery from cardiac surgery is NOT the same for an 82 y.o. as compared to a 72 y.o. is not discussed, and generally the patient thinks of self as being 72 and in relatively good health! Also, there is no discussion of the alternatives to surgery – medications and palliative care (not hospice, but sx management). The PCP rarely sees the patient after the specialist consult (esp in hospital where you have a rotating cast of hospitalists) to talk about how cardiac surgery will affect the patient overall, not just the expected cardiac improvements.
    The procedure is successful but the patient dies – or never returns to prehospitalization level of independent living.

    • glasshospital

      August 26, 2012 at 2:48 pm

      Well said. In this case, would the surgery be considered “successful” if the patient died before being discharged from the hospital? What if he’d actually survived to discharge but died before the 30 or 90 day marks?

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