“You just go ahead and thump on my chest!”

So, she’s 93 and full code.

And, yeah, she has the proverbial multiple medical problems. And, yes, she weighs, what, a hundred pounds, her ribs as much as her lips saying hello. And she’s been in the hospital, what, three, four, five times in the last, what, six, eight months.

But she also knows what she wants.

And what she wants, if her heart stops, if she stops breathing, is for us to do what I have told her we will do: CPR, and likely break her ribs, maybe puncture a lung; shock her heart, if indicated; place a tube in her throat and hook her up to a machine that will breathe for her; that the chances of us bringing her back from the dead are slim, maybe none.

“You just go ahead and thump on my chest,” she tells me with a smile, after I tell her all that.

 And I tell her okay.

Who am I to say to her, that even at 93, she doesn’t deserve this, her own take on the last rites; that, even if, we, in medicine, do what we do, that she is likely to end up in the same place, the same peace.

She is, without question, able to make decisions on her own behalf. And, given that, the fact that she is 93 has no bearing on her decision, no less than on mine, at 61, yours at 75, yours at 40.

Full code, it is.

And you’re thinking, c’mon, dude, the woman is 93, frail, in the hospital now, in the hospital all the time. And Medicare is thinking that she is costing us more than she ever paid in. And others are thinking that she, at 93, needs to know that she is done, has, at 93, nothing more to contribute.

Except, of course, her smile. Her long life. What that life taught her, taught others.

And what I’m thinking is that Thelma has autonomy. That this is her life.

End of story.