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From the Heart
July 2018

Without Words

Author Affiliations
  • 1Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
JAMA Cardiol. 2018;3(7):561-562. doi:10.1001/jamacardio.2018.0232

The only thing that Sharon lacked was the ability to breathe on her own. She had received new lungs a few years earlier in a late decade of her life. Her body had rejected these new organs, leading over time to fibrosis not only of the lung parenchyma but also the pulmonary vasculature. She was attached to a ventilator but did not let that deter her spirit, energy, or spunk.

Most patients on my morning rounds in the intensive care unit were also intubated. However, we sedated them with opiates, benzodiazepines, and other centrally acting medications to prevent them from experiencing pain and to limit their awareness of their surroundings. Sharon decided that she did not want that—she wanted to be present.

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