I’m new in this forum, just listening, hardly apprentice.

I stand to ask your warm hand to a great friend that yesterday saw his father crossing.

My phone rings:

“My father unconscious at home! You know, terminal, asymptomatic. 112 on road. Who can I speak? … My brother doing CPR with instructions by phone. I don’t know if he is in cardiac arrest.”

The ambulance arrives. He talks to the doctor…

“Unconscious but breathing, perhaps a COPD exacerbation.
– No. Several days of heart failure, edema, baseline dyspnea . I pone you because the patient does not want extraordinary measures, we have talked about it.
Salbutamol, ipratropium, furosemide. No tubes or CPR.

Transfer. Heart failure. Massive pleural effusion, more data.

Three hours of noninvasive ventilation until palliative care unit admission.

He is at bed with moments of lucidity, with the peace of drugs. The family at his side. This is the end. Good Ramsay, have a nive trip daddy!.


On his deathbed, for sure your father keeps part of the secret that, far from treasure, you share with us.

That treasure that day by day you offer us, what makes our debt more immense with you.

 Well, it is time to pay.

You know you have all our smile, our look, hand, the word, and the part of the soul that we can share.

Silently, beside you, friend Gabi.


Juan Francisco Heras Sacristán

2-4-1937 / 11-6-2015


Alfredo Serrano, Medical Emergencies