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LANGSTON'S SISTER: Langston, move your eyes for me, baby.[INAUDIBLE] Your dad's here.Your mom's on her way.You can talk to her if you like.
LOUIS THEROUX: Hi, Langston.We've come from London, England.We're making a TV program here in the hospital.And so we've been filming your family a little bitand filming with you a little bit, too.So we're hoping you're going to wake up,and we can tell you a little bit more about what we're doing.
LOUIS THEROUX [continued]: How are you feeling?
LANGSTON'S SISTER: Good.I feel really good.I know some people don't think there's a lot of progress.But something's better than nothing.There's been miracles in many hospitals,and they can't say why.So this is going to be a miracle right here.[MUSIC PLAYING]
LOUIS THEROUX: I was in Cedars-Sinair Medical Centerin Los Angeles, meeting patients lookingfor a last chance at life.
JAVIER: If I do this, I'm buying maybe months, right?
DOCTOR: It could be more than that.
JAVIER: All right, then.Let's do it.
LOUIS THEROUX: In America, doctorswill go further to treat extreme cases than almost anywhereelse in the world.
DOCTOR: He's a fighter.We decided to keep going.
AUNT BONNIE: I'd fight for life.I certainly would.I mean, what?Sit there and just die?
LOUIS THEROUX: But the financial costsare enormous, the side effects sometimes severe, and the oddsof success often very small.Patients and their families face the harrowing choiceof accepting death or carrying on in the hopethat one last procedure will pay off.
LOUIS THEROUX [continued]: [LOUIS THEROUX'S LA STORIES EDGE OF LIFE][MUSIC PLAYING]On the seventh floor of Saperstein critical care tower,Langston Jackson, a 22-year-old college athlete,
LOUIS THEROUX [continued]: was non-responsive in the intensive care unit.His family had been by his bedsidesince his arrival five days earlier,among them, his mother Nile.
LOUIS THEROUX: Can you tell me a little bitabout what's going on?
CRITICAL CARE WORKER: Well, Langstonwas in rehab for the past 19 days.And on Saturday morning, he and his roommatehad gotten in contact-- connected with drugs.And he had an overdose, from what I understand,in the facility, about 3:00 AM.
LOUIS THEROUX: What do you understand about his conditionat the moment?
CRITICAL CARE WORKER: I understand he'sin very critical condition.He has compromised liver and kidney functionand traumatic brain injury.And they are waiting for him to be able to breathe on his own,to diagnose his brain injury further.
LOUIS THEROUX: How optimistic are you for Langston?
CRITICAL CARE WORKER: Well, I understandthat this is going to take quite a while,but that he's hopefully able to walk, talk, and do everythingthat he wants to do and continue to live his life,even with limited-- marketed limitations, that's fine.
LOUIS THEROUX: In charge of Langston's carewas the ICU medical director, Dr. Heather Jones.She'd called a family meeting to discuss his prognosis.
DR. HEATHER JONES: All right.
LANGSTON'S SISTER: Is it OK if I sit with you?
DR. HEATHER JONES: OK.So what Langston has is not a blood clotthat blocked a certain part of-- a certain artery goingto a certain part of the brain.He has-- basically, certain areas of his brainwere very, very sensitive to the fact
DR. HEATHER JONES [continued]: that his oxygen level was very low.And so that's the part where it gets really heartbreaking,is that when I asked Dr. Mohit, whowas the neurointensivist who took care of himwhen he was first sick, and Dr. Palestran as well,felt that his chances of waking up and being normal again
DR. HEATHER JONES [continued]: are very small.
CRITICAL CARE WORKER: And they just said that?
DR. HEATHER JONES: Well, I think that I've been concernedabout that from the beginning.And I think that we've all been concerned about that.But time will tell.And so in the first 24 or 48, 72 hours, you hope for the best,
DR. HEATHER JONES [continued]: and you hope that what you're seeing on the scan is not real.I think that we're all sad, because I was reallyhoping he would wake up.And I know that the first night, we were--
LANGSTON'S SISTER: What do you mean hoping he would wake up?He's still planning on waking up, though, right?
DR. HEATHER JONES: Probably not.He's probably had such severe brain damagethat he's not going to wake up, that he'sgoing to be in kind of a comatose state,and that even if he does wake up,he would probably have pretty severe brain damage.
LOUIS THEROUX: So how was that, for you?
DR. HEATHER JONES: Oh, it's so hard.It's a really hard one, because-- and also, I'mtalking at them, and I know they're not hearing me.
LOUIS THEROUX: If you had allowed them to continue maybein a state of slightly unrealistic hope,what would have been the downside of that?
DR. HEATHER JONES: Well, I think they're stillin that slightly unrealistic hope.I don't think I could really penetrate that.It's going to take time.
LOUIS THEROUX: But you did your best to do that, I think.And why was that?
DR. HEATHER JONES: Well, because it's timeto start talking about that.It's not 24 hours later, it's when it is, four days laternow, five days later.So we need to start talking about those things.Because they don't hear a lot, so wehave to keep coming back to it.
DR. HEATHER JONES [continued]: [MUSIC PLAYING]
LOUIS THEROUX: I was in Cedars-Sinai South Tower,home to another group of patients fightingfor their lives against cancer.I had an appointment with Dr. [INAUDIBLE].She was visiting a leukemia patient, 29-year-old JavierGalvan.She had news about his cell count?
DOCTOR: How are you?How are you feeling, today?
ADRIANA: He looks better, right?
DOCTOR: Yeah, much better.I just wanted to tell you, the count,it looks like the absolute nutritionalcount is showing up.So it's not certain yet whether they're bador whether they're good.I know sometimes there are good ones that are justmeans that there's young cells that your bonemarrow's spitting out.And if they are the bad cells, I will really
DOCTOR [continued]: have to pick my brain on what to do next.
ADRIANA: And then we can go back to anything he's already had?
DOCTOR: I think that's still, if he's in a good enough shape,I think that's still a choice.
LOUIS THEROUX: So what are you up against right now,as you understand it?
JAVIER: As far as I understand, it's my blood.I'm fighting myself.My blood is killing me.It can't hold any nutrients.It can't do anything.It can't produce itself, and it's dying.
LOUIS THEROUX: How would you characterize it,Dr. [INAUDIBLE]?What's the scenario we're in right now?
DOCTOR: So yeah, basically, right now,we're battling acute [INAUDIBLE] leukemia.And we've been trying to kill it with a seriesof different treatments.The treatments themselves are life-threatening.
LOUIS THEROUX: If Javier died from that,what would have been the actual medical cause?
DOCTOR: It kills all the dividing cells.So it kills the lining of the gut, the lining of the mouth.So we can get terrible mouth sores.Pretty much the whole inside of the mouthcan pretty much fall off, just fall off.It's very painful.
LOUIS THEROUX: You're OK with hearing-- thisis getting kind of gruesome.Because you've already been through this.
DOCTOR: No, he already-- he went through that.He survived that.
LOUIS THEROUX: I know.But even so, it's making me feel a little bit ill.
JAVIER: You didn't hear them screaming.I've heard people screaming in the night.
LOUIS THEROUX: In the night?From what?
JAVIER: Pain.Just it's your whole body turning against you.You become-- it becomes like fireto move without anything to calm it.It consumes you.It's really terrible.And you can't do anything about it.
LOUIS THEROUX: How was the decision takento continue with all these chemotherapiesin the case of Javier?
DOCTOR: He's young.He's a fighter.His body organs overall are functioning well.We decided to keep going.
LOUIS THEROUX: What would be the reasonsnot to offer further treatments, further chemo?
DOCTOR: He's had a lot of treatment already.And his body is weak.It's weakened by so many chemotherapy treatments.They're very toxic.So at one point, the risk of treatment is so high.The risk of treatment taken in the patient's lifeis so high that a physician just don't offer it any more.
DOCTOR [continued]: And last time, I actually told himthat he may live longer just choosing comfort type of care,rather than chemotherapy, because in the short run,chemotherapy could take his life fast.But they still chose to go on with the treatment.[MUSIC PLAYING]
ADRIANA: Thas was New Year's 2010,so the year before he got sick.
LOUIS THEROUX: Before his health setbacks,Javier had been financing his dreamof becoming an x-ray technician by working in a photocopy shop.It was there that he'd met Adriana, in 2006.What was your plan before any of this happened?
ADRIANA: We were going to be a part-time jobs, because wequit our full-time jogs.Then we were going to start school.And then we were going to get married.That was the plan, pretty simple.
LOUIS THEROUX: As far as the care goesand the different stages on the journey,have you always been in sync, the two of you?
ADRIANA: He's made it very clear what he wants.And you have to-- it's his journey,and he's the one that's sick, and he'sthe one that is in charge of his own care.And I asked him, I said, well, if you don't thinkthat you can do-- if you can do it, if you can keep going,
ADRIANA [continued]: will you tell me?I would never deny that for him if that's what he chooses.But he's always been like, we can do this, I can fight this.It's OK.[MUSIC PLAYING]
LOUIS THEROUX: Javier and Langstonwere facing life-threatening conditionsin a country that leads the world in spendingon end-of-life care.
CRITICAL CARE WORKER: I'm so proud of you.
LOUIS THEROUX: The US has turned its famous senseof can do onto the problem of extreme illness.Most Americans either have health insuranceor their care is paid for by the state.For them, there is a smorgasbord of expensive treatment options,but also the question of when to stop.
LOUIS THEROUX [continued]: Back with Dr. Jones, and she had an appointmentto discuss Langston's brain scan results with her colleagueDr. Yu, a neurologist.
DR. HEATHER JONES: The best case scenariois that he might wake up, but he'll never be able to walk.He'll never be able to feed himself.Will he know who he is?Will he be able to follow commands?Best-case scenario?
DR. JOHN YU: So the best-case scenario, the patientwill probably end up in [INAUDIBLE].
DR. HEATHER JONES: That's the best-case scenario.
DR. JOHN YU: [INAUDIBLE] open eyes,yawning, or [INAUDIBLE] states with many more conscious level.
DR. HEATHER JONES: OK.All right.And that's the best-case scenario?
DR. JOHN YU: Yeah, that's [INAUDIBLE].This is a quite severe injury.
LOUIS THEROUX: What are the choices going forward, then?
DR. HEATHER JONES: I've been thinking a lot about this.If it was me, and I've told my family in no uncertain termsthat I would not want to be kept alive.They're not going to be ready to do that with him.I don't think anybody really wants that,but I think sometimes families reallyhave a hard time letting go.And my experience is that it's going to take some time.
DR. HEATHER JONES [continued]: So I wanted to talk to you guys about what's going on.I don't want to dash your hopes, but Ineed to tell you that, from a scientific medical standpoint,he's not going to wake up, and that he's had very severe braindamage, and that the best-case scenario is that he will
DR. HEATHER JONES [continued]: be in a persistent vegetative state,meaning he will be in a nursing home on two feeds.He will have a diaper.He won't be able to interact.He won't ever be able to talk again.He won't know who he is.I want you guys to think about Langston, about whether he,if he could be part of this conversation--
DR. HEATHER JONES [continued]: and let's say, not now.Let's say a month from now, if he hasn't woken up,would he want to be kept alive in that state?
MAN: I mean, I understand what you're saying.And I hear what you're saying, and Irespect, because I know doctors have to be ultra-conservative.Because if you say that he's going to be all right in this,and he's not, then we'll be leaving outof here feeling disappointed.So, I understand how that goes.
LANGSTON'S SISTER: No, he didn't know him before coming in here.But he is a fighter, and he is very stubborn,and he comes around at his own time.
MAN: And last night, I said, [INAUDIBLE] I'mgetting ready to leave.And then I said, if you hear me, open your eyes.And he opened his eye.And I was not touching.I was away.And he opened his eyes, and he looked at me.That was my experience.It wasn't yours.You weren't there.Most doctors don't have time to come and sit and watchlike the family to sit and wash.
LANGSTON'S SISTER: And then when the nurse comes around,I'm like, look.And he won't do it.And I'm like, Langston, I'm going to hurt you.
DR. HEATHER JONES: Do you want to go try right now?
LANGSTON'S SISTER: Yes.
DR. HEATHER JONES: Let's go take a look.Let's see what we can do right now.
LANGSTON'S SISTER: Hey, sweetie pie.Langston, if you hear Ashley, look over to Ashley.
DR. HEATHER JONES: Langston, squeeze my hand.Langston, squeeze my hand.
LANGSTON'S SISTER: He's way more alert when he's not drugged.
DR. HEATHER JONES: Right,
LANGSTON'S SISTER: [INAUDIBLE].
DR. HEATHER JONES: Let's see.So he has this doll's eye reflex,so I think he's probably not conscious right now.So see how they go back to the middle?That's a doll's eye reflex, so I think he's probably--
MAN: [INAUDIBLE] looking like now.
DR. HEATHER JONES: Yeah, yeah.That's not how he was.OK.OK, guys.Any other questions right now?Well, thank you for coming in.I really appreciate it.
LOUIS THEROUX: It seemed as though the doctor hadone message, and you can respectfully disagree.
LANGSTON'S SISTER: For sure.
LOUIS THEROUX: And you made that quite clear.So what point were you putting across?
LANGSTON'S SISTER: That I don't thinkwe're going to necessarily have to worry about my brotherbeing a vegetable.And even if he has a slight disability of some sort,that he will be able to cope, and itwill be a little bit better than the prognosisthat they are assuming.
LOUIS THEROUX: You don't resent them--
LANGSTON'S SISTER: For what happened?
LOUIS THEROUX:--for trying to let you know whattheir clinical impression is of the situation?
LANGSTON'S SISTER: Definitely not.We get that that's a reality.We're not delusional.We're not in a fantasy world.I know it might seem that way.But we have to be super positive whensuch great odds are against him, towards everybody else.
LOUIS THEROUX: When the doctor had said somethingabout what would Langston want if he were in the roomright now?Did you give any thought to that?
LANGSTON'S SISTER: I did.I mean, my brother, although he suffered from depressionat times, or what not, he was always full of lifeand full of hope and full of optimism in regardsto things could get better, whichis why he checked himself and stayed in the rehab.Clearly, he didn't foresee what happened happening,but he was still trying.
LANGSTON'S SISTER [continued]: So I know that he wouldn't want us to give up on him because henever gave up on himself.[MUSIC PLAYING]
LOUIS THEROUX: For patients who have stabilized in ICU,but are still not responsive, thereare other facilities that offer what iscalled long-term subacute care.One is Fountain View.Here, many of the residents are in statesof minimal consciousness that can last years.
LOUIS THEROUX [continued]: Hi.Are you Rosalie?
ROSALIE: Yes, hi.
LOUIS THEROUX: Hi.Louis.Nice to meet you.And this is Francisco?
LOUIS THEROUX: Hi, Francisco.Francisco Fahardo was a physician, originallyfrom the Philippines.He's been a full-time resident of Fountain Viewsince a stroke in 2010.His sister Rosalie is a daily visitor.The interesting thing is Francisco's faceis showing all kinds of expressions.
LOUIS THEROUX [continued]: Do you think he's registering that there'san unusual voice here?Maybe he hears.He's looking quite stimulated.Is that OK?
LOUIS THEROUX: Are you OK, Francisco?
ROSALIE: [NON-ENGLISH SPEECH]
LOUIS THEROUX: We're from the BBC.We're making a documentary about people with serious conditions,and we just wanted to get to know you a little bit.And how long has he been in this state?
ROSALIE: Three years in December.We've always hoped that one day, he would wake up.But he's made progress, at least for us.I mean, maybe the doctors might not say that that's progress.But for us family, just little things that we see different
ROSALIE [continued]: every day, from the time he got sick,that's improvement for us, no matter what it is.
LOUIS THEROUX: Have the doctors said what theyfeel is a realistic prognosis?
ROSALIE: From the start, they said that he was notgoing to recover.Like I said, we believe differently.We understand.I work in health care.I understand.But as a family, we believe differently.
LOUIS THEROUX: In the nearly three yearsthat Francisco's been in this state,have you had any words from him?
ROSALIE: No.Not words.Mostly facial expression.
LOUIS THEROUX: Dr. Michael Sofferis the director for Francisco's unit.Once a week, he makes rounds on the patients under his care.What is the prognosis like for Francisco at this point?
DR. MICHAEL SOFFER: No recovery, a few yearsuntil some event happens that results in his passing,whether it's an overwhelming pneumonia or another strokeor heart attack or any number of possibilities.
LOUIS THEROUX: Could you give an idea of whathis quality of life is like?
DR. MICHAEL SOFFER: Well, when I askpatients who are able to understand and respondappropriately if they were in a vegetative state such as this,would they want to be kept alive like this,pretty much universally they tell me no.So I don't believe that there is much quality in his unfortunate
DR. MICHAEL SOFFER [continued]: existence.
LOUIS THEROUX: Has something gone wrong with the system herein some way that these types of caseare being cared for for years and years?
DR. MICHAEL SOFFER: Years ago, 20, 30 years ago,we didn't do this.We didn't have these facilities available.And if people got to this point, where they could not functionat this level, then they died.There are always trade-offs.And when society, when we as a society,
DR. MICHAEL SOFFER [continued]: choose to spend our money on keeping the end-stage-of-lifepatients alive longer, we choose not to spend money on servicesfor other people that perhaps could benefit more.
LOUIS THEROUX: Have you ever thoughtabout if something like this were everto befall you, what you would do,what you would want done to you?
ROSALIE: I have already made that decision,because when this happened, I would do the same thing.
LOUIS THEROUX: Do you feel you still havea good relationship with him?
ROSALIE: Mm-huh, yes.
LOUIS THEROUX: Even though he's just lying there,and to some extent, he's unresponsive,you feel that there's still a--
ROSALIE: Yes.I can't explain it, but I just knowthat he knows that were here.We're looking after him.[NON-ENGLISH SPEECH] Sh-sh-sh, sh, sh, sh, sh, sh.[NON-ENGLISH SPEECH]
ROSALIE [continued]: [MUSIC PLAYING]
LOUIS THEROUX: At Cedars-Sinai South Tower, on the cancerward, I was with Dr. Richard Gould,with an appointment to meet his patient, Dante Rogers.
DR. RICHARD GOULD: [INAUDIBLE] here.
LOUIS THEROUX: Hi, Dante.
DANTE ROGERS: How are you?
LOUIS THEROUX: Good.How are you doing?
DANTE ROGERS: Good, good.
LOUIS THEROUX: Nice to meet you.
DANTE ROGERS: Nice to meet you, too.
LOUIS THEROUX: You know we're from the BBC, right?
DANTE ROGERS: Yes.
LOUIS THEROUX: From London, England.
DANTE ROGERS: Yay, viva London.Oh.
LOUIS THEROUX: Dante had come to LA with dreams of making itas an entertainer, but aged 31, had been diagnosed with cancer.With no health insurance, he qualified for public assistancefor his medical care.So how long have you two had this relationship,doctor-patient?
DR. RICHARD GOULD: Probably well over nine months now.
DANTE ROGERS: Yeah, almost five months, going on five monthsI've been here.
DR. RICHARD GOULD: Yeah, Dante was initiallydiagnosed with a locally-advanced anal cancerthat we treated with chemotherapy and radiation,with the hopes of curing.But unfortunately, the treatment it was difficult for Danteto get through.And once we got through it, therewere still active cancer there.
LOUIS THEROUX: So there was chemo and radiation,but basically, it did not eradicate the cancer?
DR. RICHARD GOULD: Exactly.
LOUIS THEROUX: So then?
DR. RICHARD GOULD: Really, the best chancethat we had at that point to try to get rid of the cancerwas to do a large surgery to remove the anal rectal cancerand to remove the spots from the liver.
DANTE ROGERS: And it saved my life, saved my life.They got rid of the cancer so far.
LOUIS THEROUX: You've basically beenresiding in the hospital for about 150 days.Is that right?
DANTE ROGERS: Close to-- well, it's more like 120-something.So probably about 125 days.
LOUIS THEROUX: And so that is a lot of medical attentionand a lot of expense.
DANTE ROGERS: I could buy two houses [INAUDIBLE],maybe have something, move to London and have a chateau.
LOUIS THEROUX: So if it's not an indelicate question,do you have a figure of how much it would have cost?
DANTE ROGERS: Well, the last timeI looked, we're probably at about $2 million,somewhere close to that.
LOUIS THEROUX: Is it helpful to talk about a time frameor how likely it is-- how long he'll live, things like that?
DR. RICHARD GOULD: I give people a general senseof how much longer I think they'regoing to live based upon days, weeks, months, or years.But I have no idea how long anybody has,cancer or no cancer.And so it's a very difficult question.It's one of the hardest questions to answer.
LOUIS THEROUX: Have you had a conversationlike that with Dante?
DR. RICHARD GOULD: I have.I have.Dante is a silver lining guy.H focused on the hope.He focuses on the good things and tryingto keep a positive attitude.So for him, thinking about, wow, the cancerhas such a high likelihood of coming back,that is hard for him.
DR. RICHARD GOULD [continued]: And so he focuses on that small percentagethat maybe the cancer won't come back.Maybe we'll be able to give him further treatmentand to get him through this.[MUSIC PLAYING]
LOUIS THEROUX: Back with Javier, and Dr. Lenorashad the results from his biopsy and his cell count.Hi, Javier.How are you feeling?
JAVIER: Cancery.Just hanging in there, just trying to get through the day.
DOCTOR: All right.So are you ready to talk?
DOCTOR: All right.So we did the bone marrow biopsy yesterday.And unfortunately, it's full of leukemia.So it's not in remission.Actually, it looks like it just grew.All the good cells [INAUDIBLE],
ADRIANA: So it went from 24% to--
DOCTOR: 95.95% less, and there are no good cells.The options remain the same, whichis one is, of course, if you feellike enough chemotherapy is enough,is to just not doing anything.
DOCTOR [continued]: The other one is a real brain twister,because I knew that that wouldn'tbe what you would want.I kind of guessed that.So we were trying to think of the treatments that could stillbenefit you.And the only one I could think of with being
DOCTOR [continued]: the more sure bet is the very firstwe gave you, because that one was the one thatkilled the leukemia.You did have the complications, but they were due to influenza.So I think that if we could stay on track, thenyou could have maintained a remission.
JAVIER: Well, I mean, we've come this far.I mean, really.You ready?
ADRIANA: I'm ready.It's up to you.
ADRIANA: Why do you have to be so efficient?
LOUIS THEROUX: What would be a reason not to do it?
DOCTOR: Well, just because, honestly,the chances of chemotherapy working after somebody alreadyhad four different chemotherapy treatments which didn't workare they less than 50%.For many people, this would just be enough.
LOUIS THEROUX: Is that a [INAUDIBLE] for you, Javier?
JAVIER: I mean, really they're offering menothing or something, so I might as well just take something.I don't see a point in not pursuing a chance.So I've got to go for it.I mean, really.
LOUIS THEROUX: If Javier decided not to do it,he wouldn't be able to go home?
DOCTOR: He would.He would just go home with--
JAVIER: And die.
DOCTOR: --basically-- yeah, just--
JAVIER: A death sentence.
ADRIANA: It would be a week or two weeks, if that.
LOUIS THEROUX: And what are you thinking, Javier?
JAVIER: I'm thinking I let everybody down.
LOUIS THEROUX: How could you feel you've let anyone down?
JAVIER: After I beat the first remission,it was kind of like, yay, I beat the first remission.So it was just kind of uplifting.And then I got a different kind of AML.And now it's like all these promises that I've madeare like completely haberdashed.
JAVIER [continued]: It's garbage.It's a garbage outcome for kind of an epic struggle.It's just-- it's a big let down, it really is.I mean, Adriana, I'm so sorry.
DOCTOR: It's OK.
JAVIER: So sorry, baby.
LOUIS THEROUX: Why would you feel you let-- Adriana,you don't feel Javier's letting you down, do you?
ADRIANA: No.It's just, I guess, another bump in the road.
LOUIS THEROUX: You feel let down by the disease,but not by Javier.
ADRIANA: It's just so aggressive.
JAVIER: How much time could I buy?
DOCTOR: It may not be that much of a difference.That's why I'm even offering this,because I think that where things are already is--
JAVIER: Already pretty dire.
DOCTOR: It's already not good, yeah, therefore, it'shard to make it too-- it's hard to make it worse, basically.
JAVIER: All right.If I do this, I'm buying maybe a month, right?
DOCTOR: Well, it depends.
ADRIANA: [INAUDIBLE] remission, then you could do transplant.It can last more than that.
DOCTOR: It could be more that.
JAVIER: All right, then let's do it.
LOUIS THEROUX: Adriana, do you havea view on what you would like the decision to be?
ADRIANA: We kind of have to go for it.It's going to be-- either it's going to be chemo or--
JAVIER: [INAUDIBLE] weeks or too many months.
ADRIANA: And we have to-- I think we'll always wonder,I guess.Or at least I will.If you tried it, would it have worked?And I like him a little bit.I want him around as much as possible.So we've got to try.
DOCTOR: All right.Oh, I know.
ADRIANA: Don't worry.He'll be fine.
LOUIS THEROUX: See you later.
DOCTOR: Now Javier's chances of survivingthis are very close to zero.Realistically, it's zero.
LOUIS THEROUX: I mean, I was in the roomwhen we were talking about this, and Ididn't get the impression that his odds were quite so slim.Do you think they understand that?
DOCTOR: Yes, I'm sure they understand,because I told him that his first choice, as I verbalizedit, was to go home and just pursue comfort measures.And usually when we say that, thatmeans that there was a very, very slim.
LOUIS THEROUX: So the textbook analysis of this situationwould be you should let him go home and be with his familyand not go through any more interventions.
LOUIS THEROUX: But you know that,and I respect your instincts for what you feel he needs.
DOCTOR: There can be so many ethics discussions about this,and there can be so many people who wouldsay, what are you guys doing?You're crazy.Send him home.This is not going to work.Why is he going to die in the hospital?But on the other hand, like I said,I hate pushing people in some direction.Because with him, I would be pushing him.
DOCTOR [continued]: This is not what he wants.He wants to keep fighting, and I just can't.I can't be breaking him.It's very tough, and it seems like it doesn't make sense,but I don't know.If I were in his shoes, I might prefer the same.[MUSIC PLAYING]
NURSE: You're going to feel a lot better after this.You've got great teeth.
NURSE: Yeah, you do have beautiful teeth.
NURSE: Did you have to go through orthodontia,or were you born lucky?[INAUDIBLE]
LOUIS THEROUX: Langston had now been in the hospitalmore than a month.His family were convinced that hewas getting better, and now even some of the nurseswere starting to see progress.
NURSE: --teeth.Have you noticed him make eye contact with you yet?
NURSE: No, I've seen him look at me and all,but I don't see him track me.But I've seen him look at me.And when he hears a sound, he reacts.
NURSE: Oh, OK.
NURSE: That I do notice.
NURSE: That's a start in the right direction.
LOUIS THEROUX: Langston, can you hear me?Langston, can you hear me?[MUSIC PLAYING]I'd arranged a visit with his sister Ashleyto try to get to know him and learna little about his football career and his brush
LOUIS THEROUX [continued]: with drugs.[MUSIC PLAYING]Hi.How are you doing?Nice to see you.We started with some old photos of Langstonwith his twin brother Loren.[MUSIC PLAYING]That's a nice one.That's you in the middle.
ASHLEY: Yeah.[VIDEO PLAYBACK]-You have someone that makes you feellike Buttercup, that's good.And if you don't have anyone that makes bright,Buttercup, or they love you, I'm just going to say, love you,and you are my Buttercup.Don't ever forget that. [INAUDIBLE][END PLAYBACK]
LOUIS THEROUX: Do you have any senseof what would have induced him to start taking serious drugs?
ASHLEY: No, I think [INAUDIBLE], it's been-- helost 11 friends in the past 2011.I think it's just--
LOUIS THEROUX: To drugs?To heroin?
ASHLEY: To heroin in Simi Valley.And so I think it's just a drug that came that followed.Some places it might be coke.Some places it might be meth.In Simi Valley, it's just heroin.
LOUIS THEROUX: Sometimes, I mean, there'sso many different reasons that people do drugs.Was there anything in his life?Did he seem troubled in any way?
LOUIS THEROUX: About what?
ASHLEY: He was like-- always had high expectations for himself.There was always competition between himand our other brother.
LOUIS THEROUX: His twin Loren?
ASHLEY: Yeah.And Loren always seemed to get it right.
LOUIS THEROUX: And Loren was doing better academically,is that right?
LOUIS THEROUX: And in any other way?
LOUIS THEROUX: Or was Loren-- is Loren a bit more of a-- I mean,would get into trouble less?
ASHLEY: He would never get in trouble.
LOUIS THEROUX: Why not?
ASHLEY: He was scared.He is scared of authority, scared of consequences,scared of things like that.We weren't.
LOUIS THEROUX: Langston had never--
LOUIS THEROUX: --been like that?
LOUIS THEROUX: Do you think he's been depressed?
ASHLEY: Yeah.We went to a USC-Cal game in San Diego.And he couldn't take the game.He was crying hysterically, and I left with him to go outside,because he just was feeling bad at the decisions that he made,and he had regrets.And he was like, he should be on the field.He could do better than any of those guys there.And it was just harder for him.
LOUIS THEROUX: Let's just say he juststays exactly where he is now.Would that be-- I mean, you'd still be OK with that?
ASHLEY: I would, but I know he's not goingto stay where he's at now.I know he's going to get better.
LOUIS THEROUX: I mean, and if you were in his position,you would want exactly the same?
ASHLEY: Mm-huh.I'm only going to die when my heart stops beatingand when I can't breathe on my own,says God, not says a human being.As long as there's life in my body, allow me to fight.[MUSIC PLAYING]
LOUIS THEROUX: At the hospital, the 24-hour vigilat Langston's bedside had been joined by a new family member.How do you do.I'm Louis.
MRS. JACKSON: [INAUDIBLE]
LOUIS THEROUX: Nice to meet you.What's your name?
MRS. JACKSON: Mrs. Jackson.
LOUIS THEROUX: Mrs. Jackson.
CRITICAL CARE WORKER: Smile, Langston.
MRS. JACKSON: Langston?
CRITICAL CARE WORKER: Langston.
MRS. JACKSON: Here's your grandmother.Come on.Turn your head over and give me a smile.Don't give me no crying now.I done came too far for tears.I've been crying for so long, I want to laugh.Come on over here.Hey, come on over here.
MRS. JACKSON [continued]: If you close your eyes, what will I do that for, huh?You think I'm going to slap you? [LAUGHING]I ain't going to hurt the baby.
LOUIS THEROUX: How would you describe Langstonbefore he got ill?
MRS. JACKSON: How would I describe him?He has always been polite.He hasn't ever talked back [INAUDIBLE].He's always been a [INAUDIBLE] child.Like I say, God forgive you.God forgive you.And he told the devil, you can hurt him,but you sure ain't going to kill him.
MRS. JACKSON [continued]: And I believe him.I'm a child of God, and all of my seeds, all of you my seed,you're hurting now, but God's goingto make you laugh at the devil, because he won't never succeed.He's not going to kill you.You're in the fog, but it's going to be clear.
MRS. JACKSON [continued]: One day, you're going to see.[MUSIC PLAYING]
LOUIS THEROUX: The image of Langston's familypraying for him was undeniably moving.It was hard not to get swept up in the emotionand the temptation to believe that an appealto the supernatural might help.More than ever, I was reminded of the resolve of familiesto keep going at any cost.
LOUIS THEROUX [continued]: It was three weeks since my first conversation with Dante.Recovery from surgery was proving slower than expected.Dr. Gould had arranged a meeting with his surgical team.
DR. RICHARD GOULD: Yeah, and now I've got the whole team here,so that we could talk with you and answerany questions that you have.[INAUDIBLE] so that we would have everybody.How are you doing?How are you feeling?
DANTE ROGERS: I'm OK.This is [INAUDIBLE] I felt.
DR. RICHARD GOULD: So we all meantto talk about where things are at with youand with your cancer and with the surgeryand with your healing and needing more pain medicine.And we've been doing everything that wecan to try to help the wound to heal.But we just hit a road block where it's nothealing any further and that the area around the wound
DR. RICHARD GOULD [continued]: is starting to break down.And so we've been talking about what our options areto try to help with that.But we wanted to get both of your surgeons in the same placeto talk with you about that.So--
DOCTOR: Well, I want CJ, since he does the most,to talk about it.
CJ: Yeah, I mean, when we look at the progression,at the time of the APR, the abdominal perineal recessionyou had, we took viable tissue and brought itinto the perineum area.And then when we look at the way it healed,well unfortunately, the surrounding tissueis not integrating the flap.And so that's what we were brainstorming about,is like what is the likelihood if we bring another tissue,
CJ [continued]: that the same type of situation will again arise and thenplace you in a worse situation than what you are at this time.
DANTE ROGERS: So what does that mean?I have to-- am I just stuck with tryingto make this heal, or what?
DR. RICHARD GOULD: Yeah, we're unfortunately at a placewhere it's not healing, and it doesn'tlook like it's going to heal.And so it's about what we can do to keep you comfortableand to take away the pain.But we're not going to be able to make it better,unfortunately.
DANTE ROGERS: OK.
DR. RICHARD GOULD: OK?So it's about looking at comfort measures and basically hospice.The best that we can do for you isto focus on not doing anything whichis going to make you feel worse, and onlygive you treatments which will help you to feel better.
DANTE ROGERS: It just seems so simple, yet so complicated.I don't understand it.
DR. RICHARD GOULD: The tissues justare killing healing, Dante.
DOCTOR: It's the toughest decision for a surgeonnot to offer surgery and for an oncologistnot to offer any treatment options.So coming to this decision, I can'timagine how hard it is on you, but it's pretty hard on us,too.
DANTE ROGERS: [INAUDIBLE].Maybe a miracle will come out of it, I don't know.
DR. RICHARD GOULD: I'll still be here checking on youand taking care of you.That hasn't changed.It's just the direction of our treatment has changed,so that we can make sure that we'rekeeping you as comfortable and as pain-free as possible.
DANTE ROGERS: OK.Thank you.
WOMAN: God is with you.You give it to God.And I know.Boy, they talked it out, though.They looked at everything.They talked it out, all those minds together.So everybody so, so cares about you and loves you.
WOMAN [continued]: You have to give it to God, sweetheart.
DANTE ROGERS: So what am I supposed to do? [INAUDIBLE]sit in a bed forever?
LOUIS THEROUX: You must be Aunt Bonnie.
AUNT BONNIE: Yes.
LOUIS THEROUX: I'm Louis.
AUNT BONNIE: Louis, nice to meet you.
LOUIS THEROUX: Nice to meet you.How are you doing?
AUNT BONNIE: Fine.Just fine.I'm just trying to absorb everythingthat's going on with Dante.I'm just shocked that a wound is going to take his life.I just can't believe that.I won't believe that.
LOUIS THEROUX: Dante, and you?What are you thinking?
DANTE ROGERS: It's even more devastating for me,because my mind has been set that I was goingto get out of here, and to see the doctors that you'velooked up to all this time, and themlook at you empty, the face.And see, I didn't want to get started again.
AUNT BONNIE: We're just hoping for a miracle.He's just a special young man to us,and we just don't-- we just can't believe this.We just can't believe this is the end.
LOUIS THEROUX: What do you think Dante's thinking?
AUNT BONNIE: I think he's devastated,and I think he's in shock.
LOUIS THEROUX: He's talking about fighting.And he's done so much fighting.And based on what the doctors are saying,it seems like maybe now isn't the time to fight.Maybe now is the time to try and be comfortable.
AUNT BONNIE: I'd fight for life.I certainly would.I mean, what, sit there and just die?No, I wouldn't do it.And I wouldn't encourage him to do it.But to lay there and just do nothing,I don't think that's the answer.
LOUIS THEROUX: It sounds like that'swhat the doctors are saying.
AUNT BONNIE: They can only do what they feelthey've been trained to do.But doctors are humans, and they make errorsjust like everybody else.Honestly, would you do that?Would you sit up?And you look like a fairly young man yourself.If someone tells you, would you lay up there and just die?
LOUIS THEROUX: It's so hard to know,till you can imagine what would begoing through your head in that situation.
AUNT BONNIE: Well, you know, I'm older.I'm in my late 50s, and I wouldn't do it.I'm not ready to give up.
LOUIS THEROUX: Are you in a positionto put your foot down and say, we want to try more things?
AUNT BONNIE: Yeah.But according to what they told me,they've gone over and beyond what they would have done.So--[MUSIC PLAYING]
LOUIS THEROUX: Two days after the bad news about his cellcount, Javier and Adriana held a small gathering of friendsand family at the hospital.
OFFICIANT: So today, Javier and Adriana proclaim their loveto the world.And everyone here, we rejoice with and for them.Javier Alonzo Galvan, do you choose Adriana GuadalupeRodriguez to be your lawfully wedded wife and your beloved?
OFFICIANT [continued]: And if so, please say I do.
JAVIER: I do.
OFFICIANT: Adriana, I give you my hand and my heart--
JAVIER: Adriana, I give you my hand and my heart--
OFFICIANT: --as I join my life to yours.
JAVIER: --as I join my life to yours.
OFFICIANT: With this ring--
JAVIER: With this ring--
OFFICIANT: --I thee wed.
JAVIER: --I thee wed.
OFFICIANT: Javier, I give you my hand and my heart--
ADRIANA: Javier, I give you my hand and my heart--
OFFICIANT: --as I join my life to yours.
ADRIANA: --as I join my life to yours.
OFFICIANT: With this ring-- with this ring--
ADRIANA: With this ring--
OFFICIANT: --I thee wed.
ADRIANA: --I thee wed.
OFFICIANT: And with all that I am--
ADRIANA: And with all that I am--
OFFICIANT: --I cherish you.
ADRIANA: I cherish you.
OFFICIANT: I love you.
ADRIANA: And I love you.
OFFICIANT: It is really a great honor and privilegeto pronounce you husband and wife.
DANTE ROGERS: Thank you.
ADRIANA: Thank you.[CHEERING AND APPLAUSE]
OFFICIANT: Mr. And Mrs. Javier and Adriana Galvan.[CHEERING AND APPLAUSE]
LOUIS THEROUX: Two days after the ceremony,Javier started a new round of chemo.He died the following day.His end was probably hastened by his treatment,but he had also died fighting.Though I'd been just a small part of Javier's last days
LOUIS THEROUX [continued]: on earth, I couldn't help grieving his loss.I realized that the young people who have hopes and dreams,to ask them not to take everything on offerto keep going, it's almost impossible.[MUSIC PLAYING]
LOUIS THEROUX [continued]: Two months after I first arrived at the hospital,I had an extraordinary call.In a turn of events, the doctors were having troubleexplaining Langston's family had got their miracle.
DR. HEATHER JONES: Hi, Langston.
MRS. JACKSON: Do you remember her?
DR. HEATHER JONES: I'm Heather.Do you remember me?Langston, who's this?Who's that?
LANGSTON: My sister.My sister.
DR. HEATHER JONES: Oh, my God.Oh, my God.Can you tell me who's that?Who's that, Langston?
LANGSTON: My sister.
DR. HEATHER JONES: Oh, your--
DR. HEATHER JONES: Oh, I'm so happy you're OK.I really am so happy.Yay.OK, I won't cry.Oh, wow.
LANGSTON: Who is that?
ASHLEY: Who is that?His name is Louis.
LOUIS THEROUX: We're from the BBC, from Britain.We've been filming you while you've been ill.This is amazing.
ASHLEY: Watch, like-- I love you, Langston.I love you, Langston.
LANGSTON: I love you, too.
ASHLEY: See?I love you, too.
LOUIS THEROUX: You don't seem that surprised.
ASHLEY: I already told you what was going to happen.I'm grateful and I'm thankful to God.And just I knew he was going to be OK,and I know he's going to get better.
LOUIS THEROUX: You believe this was a miracle?
ASHLEY: Yes.It you could [INAUDIBLE] too.
LOUIS THEROUX: So that was unexpected.
DR. HEATHER JONES: Yeah.
LOUIS THEROUX: Would you say?
DR. HEATHER JONES: Yeah, that was really unexpected.So I just called one of the neurologiststhat I was working with in the ICU.And he said it's a one in a million.
LOUIS THEROUX: To recap what had originally been said--and this is some, well, a couple of weeksago now-- was that the best case scenario wasa vegetative state with minimal higher brain function, soin a sense, that he would basicallynot follow instructions, not really be a person.
DR. HEATHER JONES: Right, exactly.
LOUIS THEROUX: And that was the best-case scenario.
DR. HEATHER JONES: That was the best-case scenario.
LOUIS THEROUX: Based on the scans.
DR. HEATHER JONES: Based on the scansand what I was told by the neurologist and my experiencewith this.So usually, if people don't wake up right away, in a week or so,then they don't wake up.
LOUIS THEROUX: Looking back on it, does that mean youand your colleagues made a mistake, in a sense?Or were you right to manage expectationsand base your assessment on the likeliest outcome?
DR. HEATHER JONES: I guess I thinkthat most people-- I think it's appropriate to say thisis the best-case scenario based on all the evidencethat we have and based on most patients in this situation.So I think it would be inappropriate to give anybody
DR. HEATHER JONES [continued]: hope when the experts, the neurointensivistsand the neurologists are saying there'sno chance for a meaningful recovery.As we say, they didn't read the textbook.He didn't read the textbook.He supposed to be brain-- a vegetable, but he's not.He's waking up.So that's a miracle, I guess.
LOUIS THEROUX: Is it possible he'll make a full recovery?
DR. HEATHER JONES: I don't know.I really don't know.God, wouldn't that be great?It'd make it really hard to have these conversationswith other families.But I think that would be amazing.That would be so exciting.[MUSIC PLAYING]
LOUIS THEROUX: I was on my way to see Dante.After five months and 10 days in the hospital,he'd taken the step of accepting that the Cedars-Sinai doctorscould do nothing further for him.How are you feeling?
DANTE: Not too good.I decided to put on my-- this is the jacket in herethat I said I was going to wear when I leave out of here.That's the one I came here in.So whatever experience I can embody and be engulfedin it and onto the new legacy.
LOUIS THEROUX: How is your outlook?
DANTE: As far as?
LOUIS THEROUX: General outlook, are you feeling positive?
DANTE: I've always been optimistic.I'm definitely-- I think this is a better move for me,because now I can look for other measures of medications.I have too much life to live.I think I can really either beat this or extend
DANTE [continued]: the time at least.
LOUIS THEROUX: Hi, Dr. Gould.
DR. RICHARD GOULD: Hi, Dante.How are you?
DANTE: Real good.
DR. RICHARD GOULD: Yeah?
DR. RICHARD GOULD: Are you comfortable?
DR. RICHARD GOULD: Good.Any pain?
DANTE: No, not so far.
DR. RICHARD GOULD: No?
DANTE: No pain.
DR. RICHARD GOULD: Once you get home,the hospice team is going to be there to help take care of you.And like we talked about before, I won't be seeing you at home,but I'll be talking with the hospice teamand helping to take care of you with them.
DANTE: It's been a pleasure working with you for 100and how many days?Lord have mercy.
DR. RICHARD GOULD: Well, putting it all together,it's probably been around nine months, maybea little longer than that.
DANTE: All right, doctor.See you soon.
DR. RICHARD GOULD: OK.Bye, Dante.
LOUIS THEROUX: Dante's been on a journey of acceptanceto do with him not really wanting to facewhat's going on to some extent.Do you know where he is on that journey now?
DR. RICHARD GOULD: He's still on that journeytowards acceptance.He's not quite there yet.Today, he was able to talk with me about hospice a little bit.It's been difficult for him to look at going home,that he's going home on hospice.He's been looking at it a lot as, well, he's just going home.He's leaving the hospital, but not really what that means,
DR. RICHARD GOULD [continued]: that it's about taking care of himas he's going through the dying processand accepting that he is dying.And even now, he's still praying and hoping for a miracle.
LOUIS THEROUX: Has there ever beena time when you felt if he had notbeen so keen on beating the cancer,that he would not have put himselfthrough so much suffering?
DR. RICHARD GOULD: His strong willpower of wanting to liveand needing to live and being willing to gothrough painful procedures and interventionsthat he knew would make him feel worse in the short term,that he knew would bring on more pain in the short term,for the chance of doing better, for the chance of being betterafterwards, because of that, yes.
DR. RICHARD GOULD [continued]: He did go through more pain and more suffering.But there's not a right or wrong way to do that,and it's a very individual decision on whether somebodyis willing to go through that.And for Dante, it was worth it.
HOSPITAL WORKER: All right, Mr. Rogers.Before we go up, could I just get a quick signature?It's just for consent for us to take you backto your aunt's, right?
HOSPITAL WORKER: All right.Here you go.Just get your signature here.
DANTE: Uh-huh.[MUSIC PLAYING][GRUNTING] Oh!Oh.[MUSIC PLAYING]
DANTE [continued]: Six weeks after he was discharged,Dante died at his Aunt Bonnie's house, surroundedby friends and family.[MUSIC PLAYING]
DR. HEATHER JONES: Oh my God.Hi, Langston.
DR. HEATHER JONES: Oh look![CLAPPING]Hi.Hi.
LOUIS THEROUX: Seven weeks after he woke upafter intensive rehabilitation at another facility,Langston paid a visit to the ICU.
DR. HEATHER JONES: Oh my God.
LOUIS THEROUX: I'm Louis.It's nice to meet you properly.
DR. HEATHER JONES: Wow.
LOUIS THEROUX: How are you feeling?
LANGSTON: I'm good.
DR. HEATHER JONES: You're good?These people, everybody is just so excited that you're here.We're just-- you're a miracle.You know that, right?
DR. HEATHER JONES: Yeah.What's the first thing you remember?
LANGSTON: Nothing really.
DR. HEATHER JONES: Then you don't remember?
DR. HEATHER JONES: Where do you remember waking up?
LANGSTON: At the other hospital.
DR. HEATHER JONES: At the other hospital.So you don't remember it, because when you woke up here,it was right before you were about to go.And that was amazing just to see that, yeah.
LOUIS THEROUX: Congratulations.
LANGSTON: Thank you.
DR. HEATHER JONES: Wow.Do you want to see the room where you were?
DR. HEATHER JONES: Yeah?Come on down.There's nobody in there, right?These are all the people that took care of you.[MUSIC PLAYING][Langston spent 37 days in an unresponsive state.][The cost of his medical care is in the millions of dollars,
DR. HEATHER JONES [continued]: to be paid by insurance.][His doctors are still unable to say exactly why he woke up,though his age played a key role.][MUSIC PLAYING]
Louis Theroux LA Stories - Edge of Life
View Segments Segment :
Louis Theroux explores end-of-life care and the desire to continue medical care, no matter what the cost. The United States leads the world in spending on end-of-life care, but there remains the question of when to stop. Theroux explores the worlds of Langston, Dante, and Javier; people who are refusing to give up against all odds.
Louis Theroux explores end-of-life care and the desire to continue medical care, no matter what the cost. The United States leads the world in spending on end-of-life care, but there remains the question of when to stop. Theroux explores the worlds of Langston, Dante, and Javier; people who are refusing to give up against all odds.