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         Sabina & Perry: A Patient's Wish

Sidebar: Documenting Your Wishes
Sidebar: What Are Advance Directives?
Sidebar: Are Living Wills Honored?
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Sabina and Perry Elfmont talked often about how they would face death. As a retired physician, 88-year-old Perry had seen many of his patients suffer at the end.

Perry had lived a rich life with his wife of more than 30 years. He had run the New York blood bank and, despite his age, he still could enjoy theater and museums. He and his 78-year-old wife traveled, making visits to his homeland of France. They took walks in New York City, where they shared an apartment. A voracious reader, Perry was fluent in five languages.

A Living Will

Pull QuotePerry told Sabina if he became seriously ill he didn't want heroic measures if it meant he wouldn't live his life to the fullest anymore. Perry had suffered three heart attacks that forced him to retire from his active physician practice after 25 years. He knew exactly what life-prolonging interventions could be imposed if he reached a critical stage. Perry completed a living will and delineated what he did not want if he became incapacitated, including resuscitation, mechanical respiration, and renal dialysis. It even included his desire to be cremated at burial.

One May morning in 1994, Perry woke up disoriented. Sabina found her husband in a state of confusion and paranoia. She immediately called his doctor.

A stroke was a possibility so he told Sabina to bring Perry immediately to Mt. Sinai Medical Center emergency room. Sabina brought a copy of his living will. Perry's cardiologist had a copy and Sabina wanted the attending doctors and hospital to know his wishes.

Do Not Resuscitate

Photo IllustrationOnce her husband was moved to a bed, Sabina informed the attending residents that he had a do not resuscitate (DNR) order. She then filed the information with the hospital. "It simply came naturally to me because I knew his opinion about having unnecessary things done."

Sabina stayed by Perry's side until Perry's son, Andrew, came by on the second day. Sabina went home to get some rest, a decision she says she will regret forever.

When she returned the next morning, her husband's hands were restrained and he looked terrible. Sabina asked what had happened. She was told that Perry had gone into respiratory arrest in the middle of the night and they had resuscitated him. Sabina looked over at Perry. He was tethered to his bed, unable to speak, unable to do anything. All the fears he had expressed in their conversations had come true.

The events of that evening are now the subject of a lawsuit between Sabina and Andrew Elfmont and Mt. Sinai. But essentially the medical resident on staff resuscitated Perry after the DNR order had been countermanded by a physician overseeing his care. Sabina says Perry's cardiologist admitted that a mistake had been made.

She confronted a neurologist who was treating her husband. "I said, 'How could you do it? A living will is a patient's wish.'" Sabina says the doctor told her his job was to keep patient's alive, not to let them die.

When she asked why her husband's hands were in restraints, she was told it was to prevent him from yanking out his tubes. "He knew exactly what he wanted to do," she said.

Twenty-Seven Months

Two days later, Perry was released from Mt. Sinai and he and Sabina spent the next 27 months together in their apartment. Although Perry could initially walk with difficulty, he was depressed and despondent. He couldn't speak, he couldn't read, and he couldn't care for himself. His friends found it hard to visit, says Sabina. She hired a nurse to care for him to help keep his life as normal as possible at home. But Perry didn't have much of a life, she says. He wouldn't get up in the morning unless Sabina woke him; he wouldn't eat unless food was put in front of him; and he couldn't hold a conversation. Toward the latter part of his life, he lost bodily function.

Pull QuoteAfter a few months at home, Perry refused to go outside. He did not want to be in a wheelchair. Sabina says she was so worried that he would commit suicide that she only left the apartment to go to the bank and supermarket.

A Widow's Crusade

In August 1996, Perry died at home at age 90. Sabina and Andrew cremated him and spread his ashes in France. While still grieving Perry's loss, Sabina has become a crusader for assuring the rights of the terminally ill. A Polish-born Holocaust survivor, Sabina says if she had been with Perry the night he almost died, she would have respected his wishes. "I wouldn't have let there be a resuscitation. As hard as that would be, I know how important it was to him."

New York attorney Lewis Fishlin, who represents Sabina and Andrew, says that Perry should have been permitted to die. "This is not a man who meandered around the subject [of death]. This is a man who focused clearly on what his wishes were and made it clearly known."

Sabina's message to others: "If you have a living will, be on top of it." Perry's experience taught her that it's not when you die, it's how you die. "A living will should be enough, but it seems it didn't work . . . Once you write a living will, put your family around the table and talk to them about it," she says. "Perry talked to me very often about it." Sabina, now 80, isn't sure whether she can sustain a legal battle with a major New York hospital but she says for Perry she must try. "I wanted to fulfill his wishes and they didn't let me."

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REAL LIFE STORIES
Mickey: Learning from Death | Joyce & Charles: The Hospice Alternative
Sabina & Perry: A Patient's Wish | Jonathan: A Planned Death
Mary & Warren: Coping with a Long-Term Illness | Claire & Don: One Family's Struggle

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