ABSTRACT
In July, Mr. Williams, at the age of 77, was hospitalized for the second time that year for symptoms of fatigue, weakness, and shortness of breath, all indicative of worsening congestive heart failure. He was treated in intensive care for five days and then spent the remaining 20 days on a general medical ward while his medications were regulated and cardiac function optimized. Mr. Williams had end-stage heart disease. He had suffered two myocardial infarctions (heart attacks), repeated episodes of ventricular tachycardia (rapid heart beat with loss of consciousness), and during that admission had to be resuscitated after experiencing a cardiac arrest. After the July hospitalization, things never returned to normal for Mr. Williams. He took eight different medications to regulate his heart, treat his congestive heart failure, and ease his constipation. He had become so weak that he could no longer hunt in the fields as he had been accustomed to doing for 60 years, care for the chickens and cows on his ranch, tend the garden, or even walk out to the mailbox to get the mail. His condition worsened so that he was forced to go from using a cane, to using a walker, to finally getting about in a wheelchair; soon, he had to also stop driving because of failing vision and poor hearing.
