The surgeon made clear that, alternatively, she could choose a palliative approach to maintain comfort. Despite his concerns, the woman opted for surgery.
The problem, said Dr. Schwarze, was that “the kind of language we use to explain surgery doesn’t really describe the experience.”
After eight hours in the operating room, the woman went to intensive care, then suffered cardiac arrest. She underwent another six-hour operation before returning to the I.C.U.
The next day, “when the surgical team saw her, they were thrilled — ‘Wow, she’s doing great,’” Dr. Schwarze said. “Then her family came in.”
The woman for years had told them, but not her surgeons, that she feared life support and nursing homes. Now — sedated, swollen, breathing through a tube — she was unable to open her eyes, speak or squeeze a hand.
Even had the procedure gone perfectly, she was bound for a nursing facility, probably permanently.
“They had no idea this was part of the routine,” Dr. Schwarze said of the stricken family. “They said, ‘This is not O.K. You can’t do this to her. You have to stop.’”
At their insistence, the hospital discontinued treatment, allowing the woman to die.
The geriatric surgery verification program, now being piloted at eight hospitals across the country, could help prevent such horrors. Eventually, patients and families will be able to choose hospitals that participate over those that don’t.