Friday 16 April 2021


 Takotsubo n. lobster trap

Takotsubo cardiomyopathy n. a broken heart; a condition, brought on by stress, disaster or loss of a loved one where the left ventricle develops a characteristic round bottomed shape (apparently similar in shape to a Japanese lobster pot) before finally calling it quits and stopping. Medical details.

If my beater gets the right training and plays its cards correctly in the rush and fuddle of an emergency, I might be able to slip off at home without the excitement of intubation, futile anti-biotic treatments, CPR and . . .  apply defibrillator paddles, "CLEAR" >!beDOOF!< like in Emergency Ward 10. As we get older, many events - a stumble, a burn, a trip, a cough from the postman, a dizzy-spell on the landing - will start the medical intervention steam-roller and we'll be bundled off to hospital where all bets are off and Advanced Healthcare Directives AHD are left behind on the fridge door.

Thoughtful longform piece in the Guardian by Kate Clanchy who lost both parents this past Coronarama Winter. TSIA: Letting go: my battle to help my parents die a good death. Her parents were middle-class lefty intellectuals who devoted quite a bit of attention to End of Life Issues, tricked about with their AHD / Living Wills [L] and of course updated them when the Mayhem in Bologna told them that intubation was a) a thing b) a thing they did not want.

Mrs Clanchy went first, her comorbidities took her away in an ambulance, her carefully crafted AHD was lost by the hospital because they really don't care about such things: they get in the way of autopilot protocols for treating a lot of people in a properly triaged order. Surgeons gonna surgeon. Nurses are dog-tired, over-extended, grossly under-paid. A sheaf of papers on an old ladys chest gets in the way of the stethoscope. And of course she got Covid, because hospital. 

The family being smart, middle-class, assertive, and attentive learned from that experience for Round Two with Mr Clanchy. "And that turned out to be the right thing to say. With that last, desperate, refusal, my father and I pass through the looking-glass into the world of those dying at home. We are amazed and grateful to find that even in January 2021 the GP will come to the house, district nurses will call twice a day and fit him with a driver for morphine and a fantastic new anti-anxiety drug". It took him 10 days to die, of a takotsubo broken heart, with Covid rather than of Covid, in his own home. Those 10 days were time enough for a a rota of friends'n'relations to take shifts sitting with him and to open the door for the district nurse twice a day for palliative. 

OK,” I say, “we won’t have any help. Please will you inform the doctors?

I hope that works as gaeilge.
 How to use a defibrillator: Don't! [not my style, thanks]

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