A 47-year-old overweight male with a history of arthrosclerosis, diabetes mellitus type 2, and coronary artery disease (CAD) is found by a neighbor unconscious and not breathing in his front lawn where he appears to have been mowing his lawn. He is rushed to a local emergency room where it is determined that he has suffered a massive inferior myocardial infarction. He is sent to the intensive care unit in critical condition where he is placed on advanced life support equipment, and several days later, it is determined that he has minimal brain activity.

After hearing her husbands condition, his tearful wife asks you how it is possible that her husbands brain might not function if it was his heart that stopped beating. How would you answer?
As the next of kin, his wife has the right to make husbands medical decisions when he is unable to. Because the length of time that this patient was in cardiac arrest appears to have been substantial, the patients recovery is highly unlikely. The medical staff gently informs the wife that she has to make a decision regarding his health care: she can withdraw care now or choose to do everything to keep him alive, even though he will most likely die. She asks you what you think she should do. With your knowledge of neurophysiology, how would you answer her?

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