Rescue me

AUSTIN-Only the occasional whir of the respirator in the corner interrupts the steady hum of medical machinery. Lines and numbers flash frenetically on a series of monitors. A game show plays, unwatched, on a television mounted on the wall of a cold room at St. David's North Austin Medical Center.

In the room Binh Trinh stares intently at his wife, Lang Yen Thi Vo, but she lies motionless on a bed. They have been married for 38 years. He leans over her, brushes her thinning hair, and tells her in Vietnamese, "I love you. Come back."

It's been years since Mrs. Vo has been "back"-back to resembling the woman who raised two daughters and a son, and possessed the strength to rescue her husband from a Vietnamese concentration camp almost three decades ago. By communicating with Mr. Trinh in code, concealing a car for a midnight escape, and arranging hiding places for her husband until they reached their getaway boat, Mrs. Vo made it possible for the couple to leave Vietnam for the United States in 1979.

"I was in the concentration camp for three years, eight months, and 28 days, and she saved me," said Mr. Trinh. "Now I have an obligation to save her."

After suffering a series of strokes between 1997 and 2003, the 63-year-old woman has lost the ability to move or speak. She has been on a ventilator since last December and suffers swings in blood pressure and blood sugar that doctors have found difficult to treat.

Doctors want to withdraw Mrs. Vo's life support, citing a 1999 Texas law that allows doctors to suspend care to patients considered medically futile. A neurologist concluded in March that she was in a "persistent vegetative state," and attending physicians over the past two months have concurred-but PVS is still a controversial diagnosis.

Members of Mrs. Vo's family dispute the diagnosis, saying that she has responded to them and had previously expressed her desire to be kept alive. Ms. Ward represents the family, which she says wants Mrs. Vo to be "stabilized to a point where they can take her home."

The Texas medical futility law requires that doctors give families 48 hours to prepare for a hospital ethics committee hearing about terminating a patient's ongoing care. If the committee sides with the doctors, family members have 10 days to find another facility for their loved one or prepare for the withdrawal of treatment.

In Mrs. Vo's case, the hospital ethics committee supports the doctors' decision, and her family has until June 5 to convince another facility to accept the woman's case. Mrs. Vo's daughter, LoAnn Trinh, an emergency medical physician practicing in Corpus Christi and in Austin, said that finding the appropriate doctors and a facility willing to accept responsibility for her mother may be particularly difficult because of her mother's dependence on both a ventilator and dialysis.

"A lot of places we've spoken to have one but not the other, and right now it would be risky to transport her in her condition," said Dr. Trinh. "They say her condition is too complex to treat, but we just want her to become stable." Mrs. Vo's Medicaid payments have run out, and she has almost exhausted her Medicare. A private-care facility in Illinois might be willing to take Mrs. Vo, but it would charge $60,000 a month to care for her and the family cannot afford that.

Elizabeth Graham, director of Texas Right to Life, said that based on the cases her organization has intervened in since 1999, money may be a driving force behind the doctors' decision to suspend treatment: "Doctors emphasize that these decisions are not financially based because they get paid for continuing treatment. However, most of the families that call us for help have poor insurance or they're on Medicaid or Medicare, and those reimbursement rates are very low, and the hospital may lose money on them."

Texas Right to Life has not intervened in this case. Meanwhile, Mrs. Vo's husband rubs a Vietnamese oil called Kwan Loong on his wife's skin, to help her muscles. It has the pungent smell of camphor.