Within an hour, all three daughters arrived at the hospital and had run up the stairs headed toward the second floor. They had only been told that their mother had taken a turn for the worse after they had left for the evening, and they were to be told more when they arrived. The two doctors were waiting for them when they got to the floor and motioned them over to a small room across from the nurse's station.
"Let's go in here for a minute."
The five people sat down at the table, three of them very anxious to know what had happened. Dr. Scott spoke first.
"While your mother was watching the speech with you tonight, she started experiencing some chest discomfort. After you left, the nurse called me in and we ran some tests. One of those tests showed she was experiencing another heart attack. We immediately took her back to the cath lab and inserted a fifth stent, this time in the left main coronary artery which was partially blocked. As we were pulling the catheter out, Dr. Nolan noticed a bulge on the abdominal aorta around the kidney area. I confirmed his diagnosis as an abdominal aneurysm. Now, I have estimated her heart function to be only about twenty-five percent, which is minimal at best, because of the multiple heart attacks. That is not good. But believe or not, the area we are most concerned about is the aneurysm. We have no idea how long it's been there. The size of it means the wall of the aorta has been stretched very thin and because of that, it could rupture at any point. And there's no treatment for it."
The two doctors looked at the three girls sitting across the table. Each of them had tears flowing down their face.
Zoey was the first to speak. "Is she in any pain?"
"No. We're keeping her sedated, and because of that, there should be no pain."
Liz spoke up. "Of course, you've notified my father."
Bob answered that. "I just got off the phone with Mr. McGarry. He's going to take care of everything. And I'm sure you'll hear from your father in a little while."
Ellie just sat silently, trying to digest everything from both a medical and personal viewpoint. Finally, she spoke. "Does Mom know?"
Francis spoke up. "I don't think so. She knew she was having another heart attack, but she was sedated just prior to the procedure and hasn't been awake since. Before she was given the medication, she did give me a message for your father but since it was private, I would rather not repeat it."
Ellie nodded. She understood their relationship was intense and they tried their best to keep it private as well. "What's her prognosis?"
Both physicians hesitated. Finally, Dr. Scott answered. "To be very blunt…"
"I want you to be."
"It's poor. She's basically has no heart muscle left and our best guess is that the aneurysm could rupture at any minute. And when that occurs, it will be instant…" Francis paused. She was having trouble saying the word.
Bob finished instead. "death."
The girls started audibly crying. It was so hard to hear that their mother was dying and there was nothing that could be done.
Although a moot point, Ellie asked her next question. "Do you need a Do Not Resuscitate form signed? Both my father and I are on her Health Power of Attorney."
"If there's not already one on the chart, then yes, we need one. Absolutely."
The only noise heard in the room was the crying coming from the Bartlet daughters as they tried to deal with the doctors' words.
Finally, Dr. Scott spoke. "Any more questions? If not, then go see your mother. She is in a stepdown room. That means she's being monitored remotely from the nurse's station, but you will have absolute privacy. She is on oxygen for comfort but no IVs per her own wishes as stated in her Living Will. Although we have sedated her, I am planning to stop that and begin some morphine just for comfort. That will allow her to regain some semblance of consciousness. If you or your father want to tell her what's going on, that's your business. We will not say a word. Some patients want to know they are dying, some do not. You know your mother best. There are no visiting restrictions. Stay with her as long as you like. If you need anything, just ask one of us or the nurses. We want to make you and her as comfortable as possible given the circumstances."
The girls nodded and left the room.
Bob turned to Francis. "That was easy compared to what Mr. McGarry is going through right now."