A talk by Matt Morgan from TBS24

4. WHAT DOES EVERY
PATIENT AND FAMILY
WANT?

5. TO MAKE SENSE OF
THEIR STORY

18. 100 EXAMS
200 ESSAYS
20 LETTERS

19. CRY
CHUCKLE
CLENTCH

20. Derek Sivers
“WHATISOBVIOUS
TOYOUIS
AMAZINGTOOTHERS”

25. Narrative vs Data
&
I Don’t Know

28. This frail patient has recurrent, resistant TTP with cerebral
involvement. He is due to start rituximab after having high dose
steroids, immunosuppressants, PLEX and TTP. He has a high urea which
is a concern given his steroid use and the possibility of GI bleeding. He
is clearly at high risk of infection and we will actively monitor for this.
Given his challenges and no evidence of seizures on an EEG, a
tracheostomy may be needed but will need to be carefully timed.
Given the benefits and burdens of this in the context of his illness and
treatments, and that he is now starting to follow some commands, we
will consider this carefully over the coming week.

29. Stock Phrases

30. WE ARE VERY
WORRIED ABOUT
YOU AND YOU ARE
SICK ENOUGH TO DIE.

31. WEAREALLWORRIEDABOUTTHISPATIENT’SMULTIPLE
MARKERSOFFRAILTYANDLIMITEDSURVIVORSHIP.
ITSEEMSTHATCONSIDERINGTHECURRENTDISEASE,THEIR
PRIORHEALTHANDWISHES,THEBURDENSOFINVASIVE
TREATMENTSLIKECPR/CVVHF/IPPVOUTWEIGHTHE
BENEFITS.
ACHANGEOFFOCUSTOSYMPTOMATICCONTROLMAYBE
THEBESTDIRECTIONTOTAKEFORTHISPATIENTANDTHEIR
FAMILY.

32. DUETOSEVERECAPACITYISSUESWHICHTHE
ORGANISATIONISAWAREOF,WECANNOT
CURRENTLYADMITTHISPATIENTDIRECTLYTO
THECRITICALCAREUNIT.

33. Dear You