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My older brother, my only sibling and my last remaining close relative, a single man with no children, had a major heart attack three weeks ago. He was out shopping and just keeled over. Never smoked, social drinker, keen golfer, no signs that this was going to happen. His heart just stopped beating. And stopped beating for several minutes.

He was lucky (or was he?) in that a passer-by  who knew how to do CPR managed to resuscitate him and apply the CPR to him until the paramedics arrived. He was taken to hospital in a coma and was put on a life-support machine. Because he had just popped to the shops and had only his wallet and a locked mobile phone on him it took the hospital almost 24 hours to work out whom to contact.

He remained on life-support and in that coma for 10 days. 10 days of not being sure if he would make it and, if he did, whether he would have sustained any brain damage.

From ICU he was moved to the High Dependency Ward and from there to Acute Cardiac and then to Cardiac. Surrounded by caring, empathetic, supportive, professional people. But a different person each day I went to visit and sit by his bed and talk to him in the hope that he hears, understands and recognises that I am there. A different nurse, doctor, consultant each day who delivers a different and inconsistent message. Mostly gloomy (‘just managing your expectations’) with sometimes a small ray of light (‘he smiled today’).

And then the talk with the man in charge. He explained to me that, as far as they could work out, my brother has extensive, irreversible, neurological damage. This consultant was the one who had been in overall control of my brother’s case and it was he who, he said, had worked tirelessly to save my brother’s life. He told me this as if he were expecting me to fall on his neck in abject gratitude for the miracle he had performed. I didn’t. Is this a life worth living?

Oddly enough I have known my brother all of my life. I know that he would not want to live a life that is not independent, to have to be cared for by others, where dignity and privacy have been lost. Is this a life worth living?

My brother is now out of the coma and off the life support but he is largely unresponsive. He cannot talk or swallow and has to be nourished through a peg fitted into his stomach. He does not recognise me. He looks at me, but he looks through me. He cannot communicate. He pulls faces. But I can’t say what they mean.

He has been transferred to a Neurological Rehab Unit where a whole team of different therapists will assess and work with him. But again, I have been advised to expect that he may well end up needing 24/7 care. Is this really a life worth living?

Fortunately he had created last autumn a Lasting Power of Attorney naming me as his attorney, which meant that when the consultant told me that he had extensive brain damage I was able to put in place a ‘Do Not Resuscitate’ order for him if his heart fails again.

Am I allowed to grieve? I don’t know. He hasn’t died. But yet I would be very hard put to say that he is living.

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