As a critical care doctor, Jessica Zitter has seen plenty of “Hail Mary” attempts to save dying patients go bad—attempts where doctors try interventions that don’t change the outcome, but do lead to more patient suffering. It’s left her distrustful of flashy medical technology and a culture that insists that more treatment is always better. But when a new patient goes into cardiac arrest, the case doesn’t play out the way Jessica expected. She finds herself fighting for hours to revive him—and reaching for a game-changing technology that uncomfortably blurs the lines between life and death. 

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Talking about end-of-life stuff can be hard! Here are some resources to get you started. (Adapted from Jessica Zitter’s Extreme Measures: Finding a Better Path to the End of Life. Thanks Jessica!)

I want to… 

...figure out what kind of care I might want at end of life:

Prepare uses videos of people thinking about their end-of-life preferences to walk you through the steps for choosing a surrogate decision maker, determining your preferences, etc. 

...talk with family/friends about my preferences (or theirs!):

The Conversation Project offers a starter kit and tools to help start the conversation. 

...put my preferences in writing (and advance directive): 

Advance Directive forms connects you to advance directive forms for your state. 

My Directives For those who like their documents in app form! Guides you through creating an end-of-life plan, then stores it in the cloud so it’s accessible anywhere. For those who like their documents in app form!

Guests

Jessica Nutik Zitter, MD, MPH, Author and Attending Physician, Division of Pulmonary/Critical Care and Palliative Care Medicine, Highland Hospital

Thomas Frohlich, MD, Chief of Cardiology, Highland Hospital

Kenneth Prager, MD, Professor of Medicine and Director of Clinical Ethics, Columbia University Medical Center

Daniela Lamas, MD, author and Associate Faculty at Ariadne Labs

David Casarett MD, author and Chief of Palliative Care, Duke University School of Medicine

Footnotes

Read the books: Jessica Zitter’s book is Extreme Measures: Finding a Better Path to the End of Life. Daniela Lamas’s book is You Can Stop Humming Now: A Doctor’s Stories of Life, Death, and In Between. David Casarett’s book is Shocked: Adventures in Bringing Back the Recently Dead

Read the memoirs of Amsterdam’s “Society in Favor of Drowned Persons,” the Dutch group that tried to resuscitate drowning victims (including Anne Wortman!)

Learn more about ECMO, its success rates, and the ethical questions it raises (Daniela also wrote an article about it here)

Read Daniela’s study about quality of life in long-term acute care hospitals (LTACHs). And for an introduction to LTACHs, here’s an overview from The New York Times

Watch Extremis, the Oscar-nominated documentary (featuring Jessica Zitter), about families facing end-of-life decisions in Highland Hospital’s ICU.

Credits

This episode of Undiscovered was reported and produced by Annie Minoff and Elah Feder. Editing by Christopher Intagliata. Original music by Daniel Peterschmidt. Fact-checking help from Michelle Harris. Special thanks to Lorna Fernandes and the staff at Highland Hospital in Oakland. Our theme music is by I Am Robot And Proud. Our mid-break theme for this episode, “No Turning Back,” is by Daniel Peterschmidt and I am Robot and Proud. Thanks to the entire Science Friday staff, the folks at WNYC Studios, and CUNY’s Sarah Fishman. Special thanks to Michele Kassemos of UCSF Medical Center, Lorna Fernandes of Highland Hospital, and the entire staff at Highland.

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