ALEXANDRIA, VA – Henry Willman, an 81-year-old man with metastatic lung cancer, hypertension, coronary artery disease, and vascular dementia became the first patient in the United States to receive the Kitchen Sink. Admitted to St. Alexis of Virginia (SAVE) after a cardiac arrest due to sepsis with multiorgan failure, his family insisted the medical team “do everything possible” to save their loved one. That is when the ICU knew it was time to throw in the Kitchen Sink.
With a respirator, hemodialysis, ECMO, continuous platelet transfusions, insulin pump, IVIG infusion, steroids, Lasix, 3 pressors, 4 antibiotics, 2 antifungals, chemotherapy, ultrasound, MRI, CT imaging, Foley catheter, artificial intelligence, limb regenerator, continuous EEG monitoring, chest tubes, drains, garbage disposal, and an actual kitchen sink with hot and cold running water, The Kitchen Sink has it all. “It’s got something for everyone,” Dr. Ann Fuhl Coad, “even if they don’t know they need it yet.”
For years, ICUs have been escalating end-of-life care for terminally-ill patients, fueled by improving technology and increased family demands. “For many patients, we just simply run out of therapies and ideas, but would love to continuing providing futile care for the next several months. And family members appreciate that we are trying every possible invasive therapy available to prolong suffering and erode dignity. Even if that includes bringing in an actual kitchen sink and placing it uncomfortably on top of their loved one.”
The Kitchen Sink, estimated to cost $5.2 million per patient per day, demonstrated improvement in patient outcomes as 25% of recipients went from “terminally ill” to “persistent vegetative state” and another 20% went from “brain dead” to “brain dead but family still hopeful for a miracle.” The remainder of the unconscious participants wished someone had read their advanced directives. Especially the part about a sink without cats.