Rest in peace

Case 1 : Elderly man with past medical history of Crohn's disease, and has had multiple abdominal surgery in the past, was admitted for acute confusion and high temperature. Blood results showed severe sepsis with a coagulopathy, while the CT abdomen showed multiple collections in the abdomen. Was transferred to the unit for stabilisation prior to surgery which involves correcting the coagulopathy with multiple blood products. Had a laparotomy by the surgeons which involved removing 3/4 of his large colon and then transferred back to the unit for further management. On Christmas eve, he suffered a massive myocardial infarction (heart attack) of which the risk of treating outweighed the benefits due to his coagulopathy. Family and unit consultants agreed for conservative management and the patient was transferred to the ward for palliative management. He died on Christmas Day.

Case 2 : Elderly woman, known alcoholic abuse, admitted on the eve of New Year's Eve for shortness of breath of 2 days duration. Daughter reports patient normally drinks a lot (unable to quantify) but has been drinking more than her usual amount since Christmas Day. Initial diagnosis was community-acquired pneumonia and was started on antibiotics. However, due to the lack of respiratory symptoms of cough or sputum, a pulmonary embolism was suspected. A CT pulmonary angiogram was performed which was unable to rule out a pulmonary embolism. Patient started on treatment for PE. While on the ward, she suffered a respiratory arrest and was found to be in pulseless electrical activity. Appropriate cardiopulmonary resuscitation (CPR) was performed. Patient intubated, ventilated and transferred to the unit on New Year's Eve. Despite adequate ventilation, she developed renal failure (requiring dialysis) and heart failure (requiring inotropes). Due to her progressive deterioration, the family and the unit consultant agreed to withdraw treatment to prevent prolonging death. Terminal weaning plan was started and the patient died on New Year's Day.

Looking at the 2 cases, they are both individuals who, despite all our intervention, did not survive. However, there is more.....

What would you say if I told you that case 1 and case 2 are husband and wife? May they both rest in peace.