Abstract

To describe individual perspective over ~30 years in a mixed Cardiac and General ICU, which includes the State Trauma Center, National Cardiac Transplant and Complex Cardiac Center, Extracorporeal Membrane Oxygenation Center, Home Ventilation Program, and the major PICU for 6 million people. Personal experience and reflection, complemented by published local data. Illustrative publications of local other data. Narrative, experiential reflection. I have agreed to palliative care in many patients of diverse religious, social, and cultural beliefs while providing long-term ICU care to other patients with similar illnesses and prognosis. This can occur when family meetings allow honest and direct conversation with respect for differences; as a clinician, I listen to a family and understand their perspectives and together develop a clear and agreed plan.

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