0:00:02 > 0:00:11This programme contains scenes which some viewers may find upsetting
0:00:12 > 0:00:15Your dad's here, your mom's on her way.
0:00:16 > 0:00:18You can talk to him, if you like.
0:00:18 > 0:00:19Hi, Langston.
0:00:20 > 0:00:24We've come from London, England. We're making a TV programme.
0:00:24 > 0:00:26You're in the hospital,
0:00:26 > 0:00:30and, so, we've been filming your family a little bit
0:00:30 > 0:00:33and filming with you a little bit, too.
0:00:35 > 0:00:37So, we're hoping you're going to wake up
0:00:37 > 0:00:41and we can tell you a little bit more about what we're doing.
0:00:45 > 0:00:47SHE SIGHS
0:00:47 > 0:00:48How are you feeling?
0:00:48 > 0:00:52Um, good, I feel really good. I know some people don't think
0:00:52 > 0:00:56there's a lot of progress but something's better than nothing.
0:00:56 > 0:00:58You know, there's been miracles
0:00:58 > 0:01:01in many hospitals and they can't say why.
0:01:02 > 0:01:06So, this is going to be a miracle right here.
0:01:12 > 0:01:15I was in Cedars-Sinai Medical Center in Los Angeles,
0:01:15 > 0:01:20meeting patients looking for a last chance at life.
0:01:20 > 0:01:24If I do this, I'm buying maybe months right?
0:01:24 > 0:01:26It could be more than that.
0:01:26 > 0:01:28All right, then, let's do it.
0:01:28 > 0:01:33In America, doctors will go further to treat extreme cases
0:01:33 > 0:01:35than almost anywhere else in the world.
0:01:35 > 0:01:40He's young, he's a fighter. We decided to keep going.
0:01:40 > 0:01:42I'd fight for life, I certainly would.
0:01:42 > 0:01:46I mean, what? Sit there, and just die?
0:01:46 > 0:01:49But the financial costs are enormous,
0:01:49 > 0:01:51the side effects sometimes severe,
0:01:51 > 0:01:54and the odds of success often very small.
0:01:56 > 0:01:59Patients and their families face the harrowing choice
0:01:59 > 0:02:02of accepting death or carrying on,
0:02:02 > 0:02:06in the hope that one last procedure will pay off.
0:02:24 > 0:02:28On the seventh floor of Saperstein Critical Care Tower,
0:02:28 > 0:02:33Langston Jackson, a 22-year-old college athlete, was non-responsive
0:02:33 > 0:02:36in the intensive-care unit.
0:02:36 > 0:02:40His family had been by his bedside since his arrival five days earlier,
0:02:40 > 0:02:43among them, his mother Lyle.
0:02:43 > 0:02:46Can you, can you tell me a little bit about what's going on?
0:02:46 > 0:02:52Well, Langston was in rehab for the past 19 days,
0:02:52 > 0:02:57and on Saturday morning, he had...
0:02:57 > 0:03:00He and his roommate had gotten in contact...
0:03:00 > 0:03:05connected with drugs and he had an overdose, from what I understand,
0:03:05 > 0:03:08from the facility, at about 3am.
0:03:08 > 0:03:12What do you understand about his condition at the moment?
0:03:12 > 0:03:15I understand he's in very critical condition.
0:03:15 > 0:03:17He has compromised liver and kidney function,
0:03:17 > 0:03:21and a traumatic brain injury.
0:03:21 > 0:03:23And they are waiting for him
0:03:23 > 0:03:27to be able to breathe on his own
0:03:27 > 0:03:30to diagnose his brain injury further.
0:03:30 > 0:03:33How optimistic are you for Langston?
0:03:33 > 0:03:36Well, I understand that this is going to take quite a while
0:03:36 > 0:03:41but that he's hopefully able to walk, talk,
0:03:41 > 0:03:44do everything that he wants to do, and continue to live his life,
0:03:44 > 0:03:49even with limited... marked limitations - that's fine.
0:03:51 > 0:03:57In charge of Langston's care was the ICU medical director Dr Heather Jones.
0:03:58 > 0:04:01She'd called a family meeting to discuss his prognosis.
0:04:03 > 0:04:07- All right. - OK if I sit next to you?
0:04:08 > 0:04:14OK. So, erm, what Langston has is not...a blood clot
0:04:14 > 0:04:16that blocked a certain part...
0:04:16 > 0:04:18A certain artery going to a certain part of the brain.
0:04:18 > 0:04:20He has...
0:04:20 > 0:04:26Basically, certain areas of his brain were very, very, er,
0:04:26 > 0:04:30sensitive to the fact that his oxygen level was very low.
0:04:30 > 0:04:35And, so, that's the part where it gets really heartbreaking,
0:04:35 > 0:04:39is that, you know, when I asked Dr Moheet,
0:04:39 > 0:04:42who was the neuro-intensivist who took care of him
0:04:42 > 0:04:45when he was first sick, and Dr Palestrant, as well,
0:04:45 > 0:04:49felt that his chances of waking up
0:04:49 > 0:04:51and being normal again
0:04:51 > 0:04:53are very small.
0:04:53 > 0:04:56And they just said that? Did they just say that?
0:04:56 > 0:04:58Well, you know, I think that, that, erm...
0:05:00 > 0:05:04I've been concerned about that from the beginning, and I think that
0:05:04 > 0:05:08we've all been concerned about that but, you know, time will tell.
0:05:08 > 0:05:14And, so, in the first 24, 48, 72 hours,
0:05:14 > 0:05:16you kind of hope for the best,
0:05:16 > 0:05:20and you hope that what you're seeing on the scan is not real.
0:05:20 > 0:05:24I think that we're all sad because I was really hoping
0:05:24 > 0:05:26he would wake up and I know that the first night...
0:05:26 > 0:05:30What do you mean, hoping he would wake up? He's still planning on waking up, though, right?
0:05:30 > 0:05:33Probably not.
0:05:34 > 0:05:37He's probably had such severe brain damage
0:05:37 > 0:05:40that he's not going to wake up.
0:05:40 > 0:05:45That he's going to be in, kind of, a comatose state and that,
0:05:45 > 0:05:46even if he does wake up,
0:05:46 > 0:05:49he would probably have pretty severe brain damage.
0:05:56 > 0:05:58How was that for you?
0:05:58 > 0:06:02Well, it's so hard. It's a really hard one cos I...
0:06:02 > 0:06:05You know, and also I'm talking at them and I know they're not...
0:06:05 > 0:06:07They're not hearing me.
0:06:07 > 0:06:12If you allowed them to continue maybe in a state of
0:06:12 > 0:06:16- slightly unrealistic...- Mm-hm. - ..hope,
0:06:16 > 0:06:19what would have been the downside of that?
0:06:19 > 0:06:22Well, I think they're still in that slightly unrealistic hope.
0:06:22 > 0:06:25I don't think I could really penetrate that, you know.
0:06:25 > 0:06:28- But you did your best to do that. - Yeah, yeah, yeah.
0:06:28 > 0:06:30And why was that?
0:06:31 > 0:06:36Well, cos it's time to start talking about that, you know.
0:06:36 > 0:06:40It's not 24 hours later, it's... What is it?
0:06:40 > 0:06:43It's four days later now, five days later, you know?
0:06:43 > 0:06:46So we need to start talking about those things, so...
0:06:46 > 0:06:51Cos they don't hear a lot, so we have to keep coming back to it.
0:07:02 > 0:07:06I was in Cedars-Sinai South Tower, home to another group of patients
0:07:06 > 0:07:10fighting for their lives against cancer.
0:07:10 > 0:07:13I had an appointment with Dr Yuliya Linhares.
0:07:13 > 0:07:18She was visiting a leukaemia patient, 29-year-old Javier Galvan.
0:07:18 > 0:07:22- She had news about his cell count. - How are you?
0:07:22 > 0:07:24- Hello.- How are you feeling today?
0:07:24 > 0:07:27- I'm OK.- He looks good, right? - Yeah, yeah. Much better.
0:07:27 > 0:07:31- Yeah.- I just wanted to tell you the counts - it looks like
0:07:31 > 0:07:34the absolute neutrophil count
0:07:34 > 0:07:36is showing up, so it's not certain
0:07:36 > 0:07:39whether they're bad or whether they're good, you know.
0:07:39 > 0:07:42Sometimes they're good ones that just means that
0:07:42 > 0:07:45they're young cells that your bone marrow is spitting out
0:07:45 > 0:07:48and if they are the bad cells...
0:07:48 > 0:07:49SHE SIGHS
0:07:49 > 0:07:54I will really have to kind of pick my brain of what to do next.
0:07:54 > 0:07:57I mean, we can't go back to anything he's already had.
0:07:57 > 0:07:58I think that's still...
0:07:58 > 0:08:02If he's in a good enough shape, I think that's still a choice.
0:08:02 > 0:08:05- OK.- So what...what are you up against right now,
0:08:05 > 0:08:07as you understand it?
0:08:09 > 0:08:13As far as I understand, it's my blood - I'm fighting myself.
0:08:13 > 0:08:15My blood is killing me.
0:08:16 > 0:08:17It can't hold any nutrients,
0:08:17 > 0:08:21it can't do anything, can't produce itself and it's dying.
0:08:21 > 0:08:23How would you characterise it, Dr Linhares?
0:08:23 > 0:08:26What's the scenario we're in right now with Javier?
0:08:26 > 0:08:31So, yeah, basically, erm, right now, erm, we're battling
0:08:31 > 0:08:33acute myeloid leukaemia,
0:08:33 > 0:08:37and we've been trying to kill it with a series of
0:08:37 > 0:08:40different treatments. The treatments themselves are life-threatening.
0:08:40 > 0:08:42If Javier had died from that,
0:08:42 > 0:08:46what would have been the actual medical cause?
0:08:46 > 0:08:48Kills all the, like, dividing cells,
0:08:48 > 0:08:51so it kills the lining of the gut, the lining of the mouth,
0:08:51 > 0:08:53so you can get terrible mouth sores.
0:08:53 > 0:08:57Pretty much the whole inside of the mouth can pretty much fall off,
0:08:57 > 0:08:59just, like, fall off. It's very painful.
0:08:59 > 0:09:02Are you OK with hearing... This is getting kinda gruesome.
0:09:02 > 0:09:04- Yeah, it's fine.- Yeah.- Cos you've already been through this.
0:09:04 > 0:09:07Already, he went through that, he survived that.
0:09:07 > 0:09:09I know. But even so, it's making ME feel a little bit ill.
0:09:09 > 0:09:13You can hear them screaming. I've heard people screaming in the night.
0:09:13 > 0:09:14In the night, from what?
0:09:14 > 0:09:16Pain. Just...
0:09:16 > 0:09:19It's your whole body turning against you.
0:09:19 > 0:09:21It becomes like fire to move.
0:09:21 > 0:09:27Without, like, anything to calm it, it consumes you.
0:09:27 > 0:09:30It's really terrible, it's pretty much...
0:09:30 > 0:09:32And you can't do anything about it.
0:09:34 > 0:09:37How was the decision taken to continue with all these
0:09:37 > 0:09:40chemotherapies in the case of Javier?
0:09:40 > 0:09:43He's young, he's a fighter.
0:09:43 > 0:09:47His body organs, overall,
0:09:47 > 0:09:51are functioning well. We decided to keep going.
0:09:51 > 0:09:55What would be the reasons not to offer further treatments,
0:09:55 > 0:09:57further chemo?
0:09:57 > 0:10:02He's had a lot of treatment already and his body is weak.
0:10:02 > 0:10:05It's weakened by so many chemotherapy treatments -
0:10:05 > 0:10:06they're very toxic.
0:10:06 > 0:10:10So, at one point, the risk of treatment is so high -
0:10:10 > 0:10:13the risk of treatment taking the patient's life is so high -
0:10:13 > 0:10:18that physicians just don't offer it any more.
0:10:18 > 0:10:23And last time, I actually told him that he may live longer
0:10:23 > 0:10:25just choosing comfort type of care
0:10:25 > 0:10:28rather than chemotherapy because, in the short run,
0:10:28 > 0:10:31chemotherapy could take his life fast,
0:10:31 > 0:10:34but they still chose to go on with the treatment.
0:10:41 > 0:10:47That was New Year's 2010, so the year before he got sick.
0:10:49 > 0:10:53Before his health set-backs, Javier had been financing his dream
0:10:53 > 0:10:57of becoming an X-ray technician by working in a photocopy shop.
0:10:57 > 0:11:01It was there that he'd met Adriana in 2006.
0:11:01 > 0:11:05- What was your plan before any of this happened?- We were going to get part-time jobs
0:11:05 > 0:11:08cos we quit our full-time jobs. Then we were going to start school
0:11:08 > 0:11:13and then we were going to get married. Yeah, that was the plan.
0:11:13 > 0:11:14Pretty simple.
0:11:14 > 0:11:18As far as the care goes and the different stages on the journey,
0:11:18 > 0:11:21have you always been in sync, the two of you?
0:11:21 > 0:11:26Erm, he's made it very clear what he wants and...
0:11:27 > 0:11:30..you know, you kind of have to...
0:11:30 > 0:11:32It's his... It's his journey
0:11:32 > 0:11:36and he's the one that's sick and he's the one that, kind of,
0:11:36 > 0:11:39is in charge of his own care. And I asked him, I said,
0:11:39 > 0:11:43"Well, if you don't think you can do it, if you can keep going
0:11:43 > 0:11:47"like, will you tell me?" I'll never deny that for him
0:11:47 > 0:11:50if that's what he chooses but, you know, he's always been, like,
0:11:50 > 0:11:54the, "We can kind of do this," like, "I can fight this," like, "It's OK."
0:12:03 > 0:12:07Javier and Langston were facing life-threatening conditions
0:12:07 > 0:12:11in a country that leads the world in spending on end-of-life care.
0:12:12 > 0:12:14So proud of you.
0:12:14 > 0:12:16The US has turned its famous sense of can-do on to the problem
0:12:16 > 0:12:18of extreme illness.
0:12:20 > 0:12:23Most Americans either have health insurance
0:12:23 > 0:12:26or their care is paid for by the state.
0:12:26 > 0:12:30For them, there is a smorgasbord of expensive treatment options.
0:12:31 > 0:12:34But also the question of when to stop.
0:12:37 > 0:12:40Back with Dr Jones, and she had an appointment to discuss Langston's
0:12:40 > 0:12:45brain scan results with her colleague Dr Yu, a neurologist.
0:12:45 > 0:12:50The best-case scenario is that he might wake up but he'll never
0:12:50 > 0:12:53be able to walk, he'll never be able to feed himself.
0:12:53 > 0:12:56Will he know who he is? Will he be able to follow commands?
0:12:56 > 0:12:58Best-case scenario.
0:12:58 > 0:13:00So, best-case scenario,
0:13:00 > 0:13:03patient will end up in a persistent vegetative state.
0:13:03 > 0:13:06- That's the best-case scenario. - He will open eyes, yawn.
0:13:06 > 0:13:09Vegetative state with a minimal conscious level.
0:13:09 > 0:13:13- OK.- All right. And that's the best-case scenario?
0:13:13 > 0:13:16Yeah. This is a pretty severe injury.
0:13:16 > 0:13:17OK.
0:13:17 > 0:13:19What are the choices going forward, then?
0:13:19 > 0:13:24It's... I've been thinking a lot about this, you know.
0:13:24 > 0:13:29If it was me - and I've told my family in no uncertain terms -
0:13:29 > 0:13:31that I would not want to be kept alive.
0:13:31 > 0:13:33They're not going to be ready to do that with him.
0:13:33 > 0:13:35I don't think anybody really wants that
0:13:35 > 0:13:39but I think sometimes families really have a hard time letting go.
0:13:39 > 0:13:43And my experience is that, you know, it's going to take some time.
0:13:46 > 0:13:51So I wanted to talk to you guys about what's going on.
0:13:51 > 0:13:54I don't want to dash your hopes
0:13:54 > 0:13:57but I need to tell you that...
0:13:57 > 0:14:01- from a scientific medical standpoint...- Yes.
0:14:01 > 0:14:03..he's not going to wake up.
0:14:03 > 0:14:06And that he's had very severe brain damage
0:14:06 > 0:14:09and that the best-case scenario is that he will be
0:14:09 > 0:14:11in a persistent vegetative state,
0:14:11 > 0:14:14meaning he will be in a nursing home,
0:14:14 > 0:14:17on tube feeds, he will have a diaper,
0:14:17 > 0:14:19he won't be able to interact,
0:14:19 > 0:14:22he won't ever be able to talk again, he won't know who he is.
0:14:22 > 0:14:24I want you guys...
0:14:25 > 0:14:27..to think about Langston,
0:14:27 > 0:14:30about whether, if he could be part of this conversation,
0:14:30 > 0:14:34and let's say not now - let's say a month from now
0:14:34 > 0:14:37if he hasn't woken up,
0:14:37 > 0:14:40would he want to be kept alive in that state?
0:14:40 > 0:14:43I mean, you know, I understand what you're saying.
0:14:43 > 0:14:46I hear what you're saying and I respect because I know doctors
0:14:46 > 0:14:47have to be ultra conservative,
0:14:47 > 0:14:50cos if you say that he's going to be all right, and this,
0:14:50 > 0:14:53and he's not, then we'll be leaving here disappointed.
0:14:53 > 0:14:54So I understand how that goes.
0:14:54 > 0:14:56You know you didn't know him before coming in here,
0:14:56 > 0:14:59but he is a fighter, and he is very stubborn
0:14:59 > 0:15:02and he comes around at his own time.
0:15:02 > 0:15:05And, last night, I said, "Hey, it's Uncle Stallion.
0:15:05 > 0:15:07"I'm getting ready to leave,"
0:15:07 > 0:15:10and then I said, "If you hear me, open your eyes."
0:15:10 > 0:15:14- And he opened his eyes? - And he opened his eyes and I was not touching, I was away,
0:15:14 > 0:15:16and he opened his eyes and he looked at me.
0:15:16 > 0:15:18That was my experience, it wasn't yours.
0:15:18 > 0:15:20You weren't there. Most doctors don't have time
0:15:20 > 0:15:23to come and sit and watch like the family sit and watch.
0:15:23 > 0:15:25When the nurse comes around we're like, "Look,"
0:15:25 > 0:15:29- and he won't do it, and I'm like, "Langston, I'm going to hurt you." - Do you want to go try now?- Yes.
0:15:29 > 0:15:32Let's go take a look, let's see what we can do right now.
0:15:34 > 0:15:35Hey, sweetie pie.
0:15:35 > 0:15:39Langston, if you hear Ashley, look over to Ashley.
0:15:39 > 0:15:41Langston, squeeze my hand.
0:15:43 > 0:15:45Langston, squeeze my hand, come on.
0:15:45 > 0:15:50- He's way more alert when he's not drugged.- Right, right. Let's see.
0:15:50 > 0:15:54So he has this doll's eye reflex so I think he's probably, you know,
0:15:54 > 0:15:57not conscious right now.
0:15:57 > 0:16:00So see how they go back to the middle?
0:16:00 > 0:16:03That's a doll's eye reflex so I think he's probably...
0:16:03 > 0:16:06- What he's looking like now...- Yeah. - That's not how he was yesterday.
0:16:06 > 0:16:08Yeah, OK.
0:16:08 > 0:16:11OK, guys, any other questions right now?
0:16:11 > 0:16:13Well, thank you for coming in. I really appreciate it.
0:16:13 > 0:16:16It seemed as though the doctor had one message
0:16:16 > 0:16:20and you, kind of, respectfully disagreed.
0:16:20 > 0:16:21For sure.
0:16:21 > 0:16:26And you made that quite clear. So what point were you putting across?
0:16:26 > 0:16:32That I don't think we're going to necessarily have to worry about
0:16:32 > 0:16:34my brother being a vegetable.
0:16:34 > 0:16:39And even if he's... You know, has a slight disability of some sort,
0:16:39 > 0:16:44that he will be able to cope and will be a little bit better
0:16:44 > 0:16:48that the prognosis that they are assuming.
0:16:48 > 0:16:53- And you don't resent them...- For what happened?- ..for trying to...
0:16:53 > 0:16:56let you know what their clinical impression is of the situation?
0:16:56 > 0:16:59Definitely not. We get that that's reality. We're not delusional,
0:16:59 > 0:17:02we're not in the fantasy world, you know.
0:17:02 > 0:17:05I know it might seem that way but we have to be super-positive
0:17:05 > 0:17:09when such great odds are against him towards everybody else.
0:17:09 > 0:17:11When the doctor had said something about,
0:17:11 > 0:17:15"What would Langston want if he were in the room now?"
0:17:15 > 0:17:17did you give any thought to that?
0:17:17 > 0:17:22I did. I mean, my brother, although he suffered
0:17:22 > 0:17:24from depression at times, or whatnot,
0:17:24 > 0:17:28he was always full of life and full of hope.
0:17:28 > 0:17:31And full of optimism in regards to things could get better
0:17:31 > 0:17:34which is why he checked himself and stayed in the rehab.
0:17:34 > 0:17:37Clearly, he didn't foresee what happened happening
0:17:37 > 0:17:41but he was still, like, trying, so I know that he wouldn't want us
0:17:41 > 0:17:44to give up on him cos he never gave up on himself.
0:17:55 > 0:17:57For patients who have stabilised in ICU
0:17:57 > 0:18:00but are still not responsive, there are other facilities
0:18:00 > 0:18:04that offer what is called long-term sub-acute care.
0:18:05 > 0:18:06One is Fountain View.
0:18:08 > 0:18:11Here, many of the residents are in states of minimal consciousness
0:18:11 > 0:18:13that can last years.
0:18:15 > 0:18:17- Hi.- Hi.
0:18:17 > 0:18:18- Are you Rosa Lee?- Yes, hi.
0:18:18 > 0:18:21- Hi. Louis.- Hi. - Nice to meet you. This is Francisco?
0:18:21 > 0:18:24- Yeah.- Hi, Francisco.
0:18:26 > 0:18:30Francisco Fahado was a physician originally from the Philippines.
0:18:30 > 0:18:33He's been a full-time resident of Fountain View
0:18:33 > 0:18:35since a stroke in 2010.
0:18:35 > 0:18:38His sister Rosa Lee is a daily visitor.
0:18:38 > 0:18:42The interesting thing is Francisco's face is showing
0:18:42 > 0:18:44all kinds of expressions.
0:18:45 > 0:18:49Do you think he's registering that there's an unusual voice here?
0:18:49 > 0:18:54Maybe he hears... He's looking quite stimulated - is that OK?
0:18:54 > 0:18:56- Yeah.- Are you OK, Francisco?
0:18:58 > 0:19:01SHE SPEAKS OWN LANGUAGE
0:19:05 > 0:19:06We're from the BBC.
0:19:06 > 0:19:10We're making a documentary about people with serious conditions.
0:19:12 > 0:19:14And we'd...
0:19:14 > 0:19:17We just wanted to get to know you a little bit.
0:19:17 > 0:19:20And how long has he been in this state?
0:19:20 > 0:19:22Three years in December.
0:19:22 > 0:19:25We've always hoped that, you know,
0:19:25 > 0:19:29one day he would wake up.
0:19:29 > 0:19:32But he's made progress, at least for us.
0:19:32 > 0:19:37I mean, maybe the doctors might not say that that's progress
0:19:37 > 0:19:41but for us, family, you know, just little things that we see
0:19:41 > 0:19:44different every day from the time he got sick -
0:19:44 > 0:19:47that's improvement for us, no matter what it is.
0:19:47 > 0:19:53Have the doctors said what they feel is a realistic prognosis?
0:19:53 > 0:19:57From the start, they said that he was not going to recover.
0:19:57 > 0:20:00And, you know, like I said, we believe differently, you know.
0:20:00 > 0:20:06We understand, you know. I work in health care and I understand
0:20:06 > 0:20:09but, you know, as a family...
0:20:10 > 0:20:13..you know, that's... We believe differently.
0:20:13 > 0:20:18In the nearly three years that Francisco has been in this state,
0:20:18 > 0:20:20have you had any words from him?
0:20:20 > 0:20:25No. No. Not words.
0:20:26 > 0:20:28Mostly facial expression.
0:20:32 > 0:20:36Dr Michael Soffer is the director for Francisco's unit.
0:20:36 > 0:20:39Once a week, he makes rounds on the patients under his care.
0:20:41 > 0:20:44What is the prognosis like for Francisco at this point?
0:20:44 > 0:20:49No recovery. A few years until some event happens
0:20:49 > 0:20:51that results in his passing,
0:20:51 > 0:20:55whether it's an overwhelming pneumonia, or another stroke,
0:20:55 > 0:20:58or heart attack, or any number of possibilities.
0:20:58 > 0:21:02Could you give an idea of what you think his quality of life is like?
0:21:02 > 0:21:07Well, when I ask patients who are able to understand
0:21:07 > 0:21:11and respond appropriately, if they were in a vegetative state
0:21:11 > 0:21:14such as this, would they want to be kept alive like this,
0:21:14 > 0:21:17pretty much universally they tell me no.
0:21:19 > 0:21:22So I don't believe that there is much quality
0:21:22 > 0:21:26in his unfortunate existence.
0:21:26 > 0:21:29Has something gone wrong with the system here in some way,
0:21:29 > 0:21:35that these types of cases are being cared for for years and years?
0:21:35 > 0:21:38Years ago - 20, 30 years ago - we didn't do this.
0:21:38 > 0:21:40We didn't have these facilities available.
0:21:40 > 0:21:44And if people got to this point where they could not function...
0:21:46 > 0:21:49..you know, at this level,
0:21:49 > 0:21:51then they died, you know.
0:21:51 > 0:21:55There are always trade-offs, and when society...
0:21:55 > 0:21:59When we as a society choose to spend our money on keeping
0:21:59 > 0:22:02the end-stage-of-life patients alive longer,
0:22:02 > 0:22:07we chose not to spend money on services for other people
0:22:07 > 0:22:09that perhaps could benefit more.
0:22:09 > 0:22:13Have you ever thought about if something like this were ever
0:22:13 > 0:22:16to befall you, what you would do?
0:22:16 > 0:22:18What you would want done to you?
0:22:18 > 0:22:21I've already made that decision cos, you know,
0:22:21 > 0:22:23when this happened, you know...
0:22:25 > 0:22:27..I would do the same thing.
0:22:27 > 0:22:28Do you feel you still have...
0:22:30 > 0:22:34- ..a good relationship with him?- Yes.
0:22:34 > 0:22:37Even though he's just lying there and, to some extent,
0:22:37 > 0:22:42- he's unresponsive, you feel that there's still...?- Yes.
0:22:43 > 0:22:48I don't... I can't explain it, but I just know that he knows...
0:22:49 > 0:22:52..we're here, you know. We're looking after him.
0:22:54 > 0:22:56MUSIC PLAYS
0:22:56 > 0:22:58SHE TALKS SOOTHINGLY
0:23:13 > 0:23:18At Cedars-Sinai South Tower, on the cancer ward,
0:23:18 > 0:23:20I was with Dr Richard Gould
0:23:20 > 0:23:24with an appointment to meet his patient, Dontay Rogers.
0:23:25 > 0:23:29- Hi, Dontay.- How are you?- Good, how are you doing?- Good. Good.
0:23:29 > 0:23:31- Nice to meet you. - Nice to meet you, too.
0:23:31 > 0:23:35- You know we're from the BBC, right? - Yes.- From London, England.- Yes.
0:23:35 > 0:23:37Viva London.
0:23:37 > 0:23:39THEY LAUGH
0:23:39 > 0:23:40DONTAY SIGHS
0:23:40 > 0:23:45Dontay had come to LA with dreams of making it as an entertainer
0:23:45 > 0:23:48but, aged 31, he'd been diagnosed with cancer.
0:23:48 > 0:23:52With no health insurance, he qualified for public assistance
0:23:52 > 0:23:54for his medical care.
0:23:54 > 0:23:58So, how long have you two been...had this relationship, doctor/patient?
0:23:58 > 0:24:01Probably a little over nine months now.
0:24:01 > 0:24:06Yeah, almost five months, so, five months I've been here.
0:24:06 > 0:24:09Yeah. Dontay was initially diagnosed with a locally advanced
0:24:09 > 0:24:13anal cancer that we treated with chemotherapy
0:24:13 > 0:24:15and radiation with the hopes of curing,
0:24:15 > 0:24:18but, unfortunately, the treatment was difficult
0:24:18 > 0:24:19for Dontay to get through
0:24:19 > 0:24:23and once we got through it, there was still active cancer there.
0:24:23 > 0:24:26So, there was chemo and radiation but, basically,
0:24:26 > 0:24:28it did not eradicate the cancer?
0:24:28 > 0:24:30- Exactly.- So, then?
0:24:30 > 0:24:34Really, the best chance that we had at that point to try
0:24:34 > 0:24:39to get rid of the cancer was to do a large surgery to remove
0:24:39 > 0:24:44the anal rectal cancer and to remove the spots from the liver.
0:24:44 > 0:24:46Yeah, it saved my life.
0:24:46 > 0:24:49Saved my life. They got rid of the cancer so far.
0:24:49 > 0:24:54You've basically been residing in the hospital for about 150 days,
0:24:54 > 0:24:58- is that right?- Close to, but it's more like 120-something days
0:24:58 > 0:25:00so about 125 days now.
0:25:00 > 0:25:05So that is a lot of...medical attention and a lot of expense.
0:25:05 > 0:25:09I could buy two houses and maybe have something...
0:25:09 > 0:25:11Move to London and have a chateau.
0:25:11 > 0:25:15So, if it's not... So, if it's not an indelicate question,
0:25:15 > 0:25:19do you have a figure of how much it would have cost?
0:25:19 > 0:25:24Well, my last bill I looked at, we're probably at about 2 million -
0:25:24 > 0:25:26somewhere close to that.
0:25:26 > 0:25:29Is it helpful to talk about...
0:25:29 > 0:25:32you know, a time frame,
0:25:32 > 0:25:34or how likely it is...
0:25:34 > 0:25:36How long he'll live, you know, things like that?
0:25:36 > 0:25:41I give people a general sense of how much longer I think
0:25:41 > 0:25:44they're going to live, based upon days, weeks, months, or years,
0:25:44 > 0:25:48but I have no idea how long anybody has, you know, cancer or no cancer.
0:25:48 > 0:25:51And so it's one of the hardest questions to answer.
0:25:51 > 0:25:54Have you had a conversation like that with Dontay?
0:25:54 > 0:25:59I have. I have. You know, Dontay is a silver-lining guy.
0:25:59 > 0:26:03You know, he focuses on the hope, he focuses on the good things
0:26:03 > 0:26:08and trying to keep a positive attitude. So for him thinking about,
0:26:08 > 0:26:11"Well, the cancer has such a high likelihood of coming back,"
0:26:11 > 0:26:13that is hard for him.
0:26:13 > 0:26:18And so he focuses on that small percentage
0:26:18 > 0:26:20that maybe the cancer won't come back,
0:26:20 > 0:26:22maybe we'll be able to give him further treatments,
0:26:22 > 0:26:24and to get him through this.
0:26:33 > 0:26:34Back with Javier -
0:26:34 > 0:26:39and Dr Linhares had the results from his biopsy and his cell count.
0:26:39 > 0:26:41Hi, Javier. How are you feeling?
0:26:41 > 0:26:44Cancery. THEY LAUGH
0:26:44 > 0:26:45Just, er, hanging in there.
0:26:47 > 0:26:49Just trying to get through the day.
0:26:49 > 0:26:52All right, so are you ready to talk?
0:26:52 > 0:26:57- Sure.- All right, so we did the bone-marrow biopsy yesterday
0:26:57 > 0:27:02and, unfortunately, it's full of leukaemia.
0:27:02 > 0:27:05So it's not in remission.
0:27:05 > 0:27:08Actually, it looks like it just grew.
0:27:08 > 0:27:11All the good cells, again, are down.
0:27:11 > 0:27:14- So it went from 24% to...?- 95.
0:27:14 > 0:27:18- OK.- 95% less,
0:27:18 > 0:27:19and there are no good cells.
0:27:19 > 0:27:22The options remain the same...
0:27:24 > 0:27:28..which is...one is, of course, if you feel like
0:27:28 > 0:27:29enough chemotherapy is enough,
0:27:29 > 0:27:33is to just not do anything.
0:27:33 > 0:27:36The other one is a real, erm,
0:27:36 > 0:27:41you know, brain twister because I knew that that wouldn't be what
0:27:41 > 0:27:44you would want. I kind of guessed that.
0:27:44 > 0:27:48So, erm, we were trying to think of
0:27:48 > 0:27:52the treatments that could still benefit you
0:27:52 > 0:27:55and the only one I could think of
0:27:55 > 0:27:59with there being the most sure bet is the very first
0:27:59 > 0:28:02we gave you because that one was the one that killed the leukaemia.
0:28:02 > 0:28:07You did have the complications but they were due to influenza.
0:28:07 > 0:28:11So, erm, I think that if we could stay on track,
0:28:11 > 0:28:14then you could have maintained the remission.
0:28:14 > 0:28:16I mean, we've come this far. I mean...
0:28:16 > 0:28:18- Yeah.- Really.
0:28:21 > 0:28:22You ready?
0:28:22 > 0:28:23I'm ready. It's up to you.
0:28:23 > 0:28:26- Yeah.- Why do you have to be so efficient?
0:28:26 > 0:28:29What would be a reason not to do it?
0:28:29 > 0:28:33Well, just because, honestly, the chances of chemotherapy working
0:28:33 > 0:28:37after somebody already had four different chemotherapy treatments
0:28:37 > 0:28:42which didn't work are less than 50%.
0:28:42 > 0:28:45For many people, this would just be enough.
0:28:45 > 0:28:48Is that a factor for you, Javier?
0:28:48 > 0:28:51I mean, really, they're offering me nothing or something,
0:28:51 > 0:28:55so I might as well just take something.
0:28:55 > 0:28:59I don't see a point in not pursuing a chance.
0:29:01 > 0:29:05So...I've gotta go for it. I mean, really.
0:29:05 > 0:29:09If Javier decided not to do it, he wouldn't be able to go home?
0:29:09 > 0:29:14He would. He would just go home with basically... Yeah, just...
0:29:14 > 0:29:16A death sentence.
0:29:16 > 0:29:19It would be, like, a week or two weeks - if that.
0:29:21 > 0:29:23And what are you thinking, Javier?
0:29:23 > 0:29:26I'm thinking I've let everybody down.
0:29:26 > 0:29:28How could you feel you've let anyone down?
0:29:28 > 0:29:34After I beat the first remission, it was kind of like, "Yay,"
0:29:34 > 0:29:36you know, "I beat the first remission."
0:29:37 > 0:29:40So, it was just kind of uplifting.
0:29:40 > 0:29:46And then I got a different kind of AML and now it's like
0:29:46 > 0:29:50all these promises that I've made are, like, completely haberdash,
0:29:50 > 0:29:53it's just garbage.
0:29:53 > 0:29:56It's a garbage outcome for...
0:29:56 > 0:30:00kind of an epic struggle. It's just...
0:30:00 > 0:30:02It's a big let down.
0:30:02 > 0:30:04It really is.
0:30:05 > 0:30:07I mean, Adriana, like...
0:30:10 > 0:30:12..I'm so sorry.
0:30:13 > 0:30:16What can you do?
0:30:16 > 0:30:19- It's OK.- I'm so sorry, baby.
0:30:19 > 0:30:21Why would you feel you're...
0:30:21 > 0:30:23Adriana, you don't feel Javier's letting you down, do you?
0:30:23 > 0:30:28No. It's just, you know, I guess another bump in the road.
0:30:28 > 0:30:32You feel let down by the disease, but not by Javier.
0:30:32 > 0:30:34It's just so aggressive, you know?
0:30:34 > 0:30:37How much time could I buy?
0:30:37 > 0:30:39It may not be that much of a difference.
0:30:39 > 0:30:41That's why I'm even offering this
0:30:41 > 0:30:45because I think that where things are already is...
0:30:45 > 0:30:46Already pretty dire.
0:30:46 > 0:30:48It's already not good, yeah,
0:30:48 > 0:30:51therefore it's hard to make it too...
0:30:51 > 0:30:53It's hard to make it worse, basically.
0:30:53 > 0:30:57All right. If I do this, I'm buying maybe months, right?
0:30:57 > 0:30:59Well, it depends.
0:30:59 > 0:31:01If you're in remission then you could do a transplant,
0:31:01 > 0:31:04- so more than months.- If it works, it could be more than that.
0:31:04 > 0:31:06Right, then let's do it.
0:31:06 > 0:31:10Adriana, do you have a view on what you would like the decision to be?
0:31:10 > 0:31:13We kind of have to go for it, you know?
0:31:13 > 0:31:17It's going to be... Either it's going to be chemo, or...
0:31:17 > 0:31:19It's going to be weeks or it's going to be months.
0:31:19 > 0:31:22I mean, we kind of have to...
0:31:22 > 0:31:23I think we'll always kind of wonder,
0:31:23 > 0:31:25I guess - or at least I will - you know,
0:31:25 > 0:31:28if you tried it, would it have worked?
0:31:28 > 0:31:30And, you know, I kind of like him a little bit.
0:31:30 > 0:31:33I want him around as much as possible!
0:31:33 > 0:31:35So we've got to try.
0:31:35 > 0:31:38OK, all right.
0:31:38 > 0:31:40Oh, I know.
0:31:40 > 0:31:42Don't worry, he'll be fine.
0:31:42 > 0:31:44See you later.
0:31:45 > 0:31:50Now Javier's chances of surviving this
0:31:50 > 0:31:53are very close to zero.
0:31:53 > 0:31:59Realistically, it's...zero.
0:31:59 > 0:32:02I mean, I was in the room when we were talking about this,
0:32:02 > 0:32:08and I didn't get the impression that his odds were quite so slim.
0:32:08 > 0:32:10Do you think they understand that?
0:32:10 > 0:32:11Yes, I'm sure they understand
0:32:11 > 0:32:15because I, er, told him that his, er...
0:32:15 > 0:32:18first choice, as I verbalised it, was to go home
0:32:18 > 0:32:22and just pursue comfort measures. And, er,
0:32:22 > 0:32:28usually when we say that, that means that the odds are very, very slim.
0:32:28 > 0:32:31So the textbook analysis of this situation would be,
0:32:31 > 0:32:36you should let him go home and be with his family
0:32:36 > 0:32:40- and not go through any more interventions?- Yeah.
0:32:40 > 0:32:43But you know that and, you know, I respect your instincts
0:32:43 > 0:32:46for what you feel he needs.
0:32:46 > 0:32:50There can be so many ethics discussions about this,
0:32:50 > 0:32:55and there can be so many people who would say, "What are you guys doing?
0:32:55 > 0:32:59"You're crazy. Send him home - this is not going to work.
0:32:59 > 0:33:01"Why is he going to die in the hospital?"
0:33:01 > 0:33:04But on the other hand, like I said,
0:33:04 > 0:33:07I hate pushing people in some direction
0:33:07 > 0:33:10because with him I would be pushing him. This is not what he wants -
0:33:10 > 0:33:13he wants to keep fighting - and I just...
0:33:13 > 0:33:18I can't, I can't be breaking him. It's very tough
0:33:18 > 0:33:22and it seems like it doesn't make sense, but...
0:33:22 > 0:33:26I don't know - if I were in his shoes, I might prefer the same.
0:33:35 > 0:33:39You're going to feel a lot better after this. You got great teeth.
0:33:39 > 0:33:42Did you have to go through orthodonture or were you born lucky?
0:33:43 > 0:33:47Langston had now been in the hospital more than a month.
0:33:47 > 0:33:49His family were convinced that he was getting better,
0:33:49 > 0:33:53and now even some of the nurses were starting to see progress.
0:33:53 > 0:33:56Have you noticed any eye contact with you yet?
0:33:56 > 0:34:00No, I see him look at me but I don't see him track me,
0:34:00 > 0:34:04but I've seen him look at me and when he hears a sound he reacts.
0:34:04 > 0:34:06- Oh, OK.- That I do notice.
0:34:06 > 0:34:09- That's a start in the right direction.- Yeah.
0:34:09 > 0:34:12Langston? Can you hear me?
0:34:15 > 0:34:17Langston, can you hear me?
0:34:22 > 0:34:26I'd arranged a visit with his sister Ashley to try to get to know him
0:34:26 > 0:34:29and learn a little about his football career
0:34:29 > 0:34:30and his brush with drugs.
0:34:32 > 0:34:36- Hi.- Hi.- How are you doing? Nice to see you.
0:34:36 > 0:34:39'We started with some old photos of Langston
0:34:39 > 0:34:42'with his twin brother Lorne.'
0:34:44 > 0:34:47That's a nice one. That's you in the middle.
0:34:47 > 0:34:48Yeah.
0:34:50 > 0:34:54'If you have someone that makes you feel like a buttercup,
0:34:54 > 0:34:55'that's good.
0:34:55 > 0:34:58'If you don't have that anyone makes you feel like a buttercup,
0:34:58 > 0:35:01'or doesn't love you, I'm just going to say it - I love you
0:35:01 > 0:35:03'and you are my buttercup.
0:35:03 > 0:35:06'Don't ever forget that.'
0:35:06 > 0:35:09Do you have any sense of what would have induced him
0:35:09 > 0:35:11to start taking serious drugs?
0:35:11 > 0:35:14No, I think, you know, in Simi Valley it's been an epidemic.
0:35:14 > 0:35:17He's lost 11 friends in the past... Since 2011.
0:35:17 > 0:35:19- I think it's just... - To drugs, to heroin?
0:35:19 > 0:35:22To heroin, in Simi Valley, so I think it's just a drug that came,
0:35:22 > 0:35:24that followed. Some places it might be coke,
0:35:24 > 0:35:28some places it might be meth, in Simi Valley it's just heroin.
0:35:28 > 0:35:29Sometimes...I mean, there's
0:35:29 > 0:35:32so many different reasons that people do drugs - was there
0:35:32 > 0:35:36anything in his life that was... Did he seem troubled in any way?
0:35:36 > 0:35:38- Yeah.- About what?
0:35:38 > 0:35:41He was, like...always had high expectations for himself.
0:35:41 > 0:35:44There was always competition between him and our other brother.
0:35:44 > 0:35:46- His twin, Lorne?- Yeah.
0:35:46 > 0:35:50And Lorne always seemed to get it right and, you know...
0:35:50 > 0:35:53And Lorne was, er, doing better academically - is that right?
0:35:53 > 0:35:55- Correct.- And in any other way?
0:35:55 > 0:35:57No.
0:35:57 > 0:36:00Or was he just... Was Lorne... Is Lorne a bit more of a...
0:36:00 > 0:36:03I mean, would get into trouble less?
0:36:03 > 0:36:04He would never get in trouble.
0:36:04 > 0:36:06- Why not?- He was scared.
0:36:06 > 0:36:10He was scared of authority, scared of consequences,
0:36:10 > 0:36:12scared of things like that. We weren't.
0:36:12 > 0:36:15- Langston has never been like that? - No.
0:36:15 > 0:36:17Do you think he's been depressed?
0:36:17 > 0:36:22Yeah. We went to a USC Cow Game in San Diego
0:36:22 > 0:36:25and he couldn't take the game.
0:36:25 > 0:36:28Like, he was crying hysterically and I left with him to go outside
0:36:28 > 0:36:31because he just was feeling bad at the decisions that he'd made
0:36:31 > 0:36:34and he had regrets, and he was, like, he should be on the field,
0:36:34 > 0:36:37he could do better than any of those guys there
0:36:37 > 0:36:38and it was just harder for him.
0:36:38 > 0:36:41Let's just say he stays exactly where he is now -
0:36:41 > 0:36:45would that be... I mean, you'd still be OK with that?
0:36:45 > 0:36:48I would, but I know he's not going to stay where he's at now.
0:36:48 > 0:36:50I know he's going to get better.
0:36:50 > 0:36:55I mean, if you were in his position, you would want exactly the same?
0:36:55 > 0:36:58I'm only going to die when my heart stops beating
0:36:58 > 0:37:04and when I can't breathe on my own, says God, not says a human being.
0:37:05 > 0:37:08As long as there's life in my body, allow me to fight.
0:37:14 > 0:37:18At the hospital, the 24-hour vigil at Langston's bedside
0:37:18 > 0:37:22had been joined by a new family member.
0:37:22 > 0:37:25How do you do? I'm Louis. Nice to meet you. What's your name?
0:37:25 > 0:37:27- Miss Jackson.- Miss Jackson.
0:37:27 > 0:37:33- Langston? - Langston.- It's your grandmother.
0:37:33 > 0:37:36Come on, turn your head over and give me a smile.
0:37:36 > 0:37:38Don't give me no crying now.
0:37:38 > 0:37:44I came too far for tears. I've been crying for so long I want to laugh.
0:37:47 > 0:37:50Come on over here. Hey! Come on over here.
0:37:52 > 0:37:56What do you close your eyes when I do that for?
0:37:56 > 0:37:57You think I'm going to slap you?
0:37:57 > 0:37:59- SHE CHUCKLES - Granny ain't going to hurt the baby!
0:37:59 > 0:38:03How would you describe Langston before he got ill?
0:38:03 > 0:38:04How would I describe him?
0:38:04 > 0:38:06He has always been polite.
0:38:06 > 0:38:10He hasn't ever talked back dirty.
0:38:10 > 0:38:13He's always been a malleable child.
0:38:13 > 0:38:18Like I say, God forgive you. God forgive you.
0:38:20 > 0:38:24And he told the devil you can hurt him but you sure ain't going to kill him.
0:38:25 > 0:38:31And I believe it. I'm a child of God and all of my seeds...
0:38:32 > 0:38:36All of you are my seed. You're hurting now.
0:38:37 > 0:38:41God's going to make you laugh at the devil,
0:38:41 > 0:38:43cos he won't never succeed.
0:38:43 > 0:38:44He's not going to carry you.
0:38:44 > 0:38:48You're in the fog, but it's going to be clear.
0:38:48 > 0:38:50One day you're going to see.
0:38:53 > 0:38:55The image of Langston's family praying for him
0:38:55 > 0:38:57was undeniably moving.
0:38:58 > 0:39:01It was hard not to get swept up in the emotion
0:39:01 > 0:39:03and the temptation to believe
0:39:03 > 0:39:05that an appeal to the supernatural might help.
0:39:07 > 0:39:10More than ever, I was reminded of the resolve of families
0:39:10 > 0:39:13to keep going at any cost.
0:39:15 > 0:39:19It was three weeks since my first conversation with Dontay.
0:39:19 > 0:39:23Recovery from surgery was proving slower than expected.
0:39:23 > 0:39:26Dr Gould had arranged a meeting with his surgical team.
0:39:26 > 0:39:29Yeah, I've got the whole team here, so...
0:39:29 > 0:39:32So that we could talk with you and answer any questions
0:39:32 > 0:39:35that you have, so we would have everybody.
0:39:35 > 0:39:38How are you doing? How are you feeling?
0:39:38 > 0:39:41I'm OK, just trying to position myself.
0:39:41 > 0:39:46So we all met to talk about, er, where things are at with you
0:39:46 > 0:39:49and with your cancer and with the surgery
0:39:49 > 0:39:52and with your healing and needing more pain medicine and, er,
0:39:52 > 0:39:57we've been doing everything that we can to help the wound to heal,
0:39:57 > 0:40:01but we just hit a roadblock where it's not healing any further
0:40:01 > 0:40:04and that the area around the wound is starting to break down.
0:40:04 > 0:40:09And so we've been talking about what our options are to try to help with that.
0:40:09 > 0:40:12We wanted to get both of your surgeons in the same place
0:40:12 > 0:40:15to talk with you about that, so...
0:40:17 > 0:40:22I want CJ, since he does the most, to talk about it.
0:40:22 > 0:40:25Yeah, I mean, when we look at the progression
0:40:25 > 0:40:29at the time of the APR, the abdominoperineal resection,
0:40:29 > 0:40:32you had, you know, we took viable tissue and we bought it into
0:40:32 > 0:40:36the perineum area and then when we look at the way it healed,
0:40:36 > 0:40:40unfortunately the surrounding tissue is not integrating the flap,
0:40:40 > 0:40:42and so that's what we were brainstorming about
0:40:42 > 0:40:45is like, what are the likelihoods if we bring in other tissue
0:40:45 > 0:40:48that the same type of situation will again arise
0:40:48 > 0:40:51and place you in a worse situation then you are at this time?
0:40:51 > 0:40:55So what does that mean? I have to...
0:40:55 > 0:41:00Am I just stuck with, er, trying to make this heal or what?
0:41:00 > 0:41:04Yeah, we're unfortunately at a place where it's not healing
0:41:04 > 0:41:08and it doesn't look like it's going to heal. And so it's about
0:41:08 > 0:41:12what we can do to keep you comfortable and to take away the pain
0:41:12 > 0:41:15but we're not going to be able to make it better, unfortunately.
0:41:17 > 0:41:20- OK.- OK?
0:41:20 > 0:41:24So it's about looking at comfort measures and, basically, hospice.
0:41:24 > 0:41:28The best that we can do for you is to focus on not doing anything
0:41:28 > 0:41:30which is going to make you feel worse
0:41:30 > 0:41:33and only give you treatments which will help you to feel better.
0:41:33 > 0:41:39It seems so simple yet so complicated. I don't understand it.
0:41:39 > 0:41:42The tissues just aren't healing, Dontay.
0:41:42 > 0:41:43You know, it's the toughest decision
0:41:43 > 0:41:48for a surgeon not to offer surgery,
0:41:48 > 0:41:51and for an oncologist not to offer any treatment options,
0:41:51 > 0:41:56so coming to this decision, you know...
0:41:56 > 0:42:00I can't imagine how hard it is on you but it's pretty hard on us too.
0:42:02 > 0:42:04Thank you for the news, and...
0:42:04 > 0:42:08maybe a miracle will happen, I don't know.
0:42:08 > 0:42:11We'll still be here checking on you and taking care of you -
0:42:11 > 0:42:12that hasn't changed.
0:42:12 > 0:42:16It's just the direction of our treatment has changed
0:42:16 > 0:42:20so that we can make sure that we're keeping you as comfortable
0:42:20 > 0:42:21and as pain-free as possible.
0:42:21 > 0:42:22OK.
0:42:25 > 0:42:28- Thank you.- You're welcome.
0:42:31 > 0:42:33God is with you.
0:42:34 > 0:42:39Give in to God, and I know...
0:42:39 > 0:42:43Boy, they talked it out, though. They looked at everything,
0:42:43 > 0:42:44they talked it out.
0:42:44 > 0:42:49All those minds together, because everybody so...
0:42:49 > 0:42:53so cares about you and loves you.
0:42:53 > 0:42:55You have to give in to God, sweetheart.
0:42:55 > 0:42:57So what am I supposed to do?
0:42:57 > 0:42:59Am I just supposed to sit in a bed for ever?
0:43:08 > 0:43:10You must be Aunt Bonnie?
0:43:10 > 0:43:11- Yes.- I'm Louis.
0:43:11 > 0:43:12Louis, nice to meet you.
0:43:12 > 0:43:14Nice to meet you. How are you doing?
0:43:14 > 0:43:16Fine. Just...fine.
0:43:16 > 0:43:21Just trying to absorb everything that's going on with Dontay.
0:43:23 > 0:43:28I'm just shocked that a wound is going to take his life.
0:43:28 > 0:43:32I-I-I just can't believe that. I-I won't believe that.
0:43:32 > 0:43:35Dontay, and you? What are you thinking?
0:43:35 > 0:43:39It's even more devastating for me because my mind has been set
0:43:39 > 0:43:44that I was going to get out of here and um, you know, the...
0:43:44 > 0:43:47To see the doctors that you've looked up to
0:43:47 > 0:43:52through all this time and them look at you empty in the face and...
0:43:52 > 0:43:55See, I didn't want to get started again.
0:43:57 > 0:43:59We're just hoping for a miracle.
0:43:59 > 0:44:03He's just a special young man to us
0:44:03 > 0:44:06and, er, we just don't...
0:44:06 > 0:44:10We just can't believe this. We just can't believe this is the end.
0:44:10 > 0:44:12What do you think Dontay's thinking?
0:44:12 > 0:44:16I think he's devastated and I think he's in shock.
0:44:16 > 0:44:21He's talking about fighting and he's done so much fighting,
0:44:21 > 0:44:23and based on what the doctors are saying,
0:44:23 > 0:44:28it seems like maybe now isn't the time to fight, you know.
0:44:28 > 0:44:31Maybe now is the time to try and be comfortable...
0:44:31 > 0:44:33I'd fight for life - I certainly would.
0:44:33 > 0:44:36I mean, what? Sit there and just die?
0:44:36 > 0:44:40No, I wouldn't do it and I wouldn't encourage him to do it.
0:44:40 > 0:44:44But to lay there and just, you know, do nothing -
0:44:44 > 0:44:46I don't think that's the answer.
0:44:46 > 0:44:49It sounds like that's what the doctors are saying.
0:44:49 > 0:44:54They can only do what they feel they've been trained to do, you know,
0:44:54 > 0:44:59but doctors are humans and they make errors just like everybody else.
0:44:59 > 0:45:02Honestly, would you do that? Would you sit up...
0:45:02 > 0:45:05You look like a fairly young man yourself.
0:45:05 > 0:45:08If someone told you, would you lay up there and just die?
0:45:08 > 0:45:12It's so hard to know, to even imagine what would be going
0:45:12 > 0:45:15through your head in that situation.
0:45:15 > 0:45:20Well, you know, I'm older - I'm in my late 50s - and I wouldn't do it.
0:45:20 > 0:45:23I've...I'm not ready to give up.
0:45:23 > 0:45:26Are you in a position to, sort of, put your foot down
0:45:26 > 0:45:29and say, "We want to try more things"?
0:45:29 > 0:45:34Yeah, but according to what they told me, they've gone over
0:45:34 > 0:45:37and beyond what they would have done.
0:45:39 > 0:45:40So...
0:45:58 > 0:46:02Two days after the bad news about his cell count, Javier and Adriana
0:46:02 > 0:46:05held a small gathering of friends and family at the hospital.
0:46:06 > 0:46:10So today Javier and Adriana proclaim their love to the world,
0:46:10 > 0:46:13and everyone here, we rejoice with and for them.
0:46:13 > 0:46:17Javier Alonso Galvan,
0:46:17 > 0:46:21do you choose Adriana Guadalope Rodriguez
0:46:21 > 0:46:26to be your lawfully wedded wife and your beloved one?
0:46:26 > 0:46:28And if so, please say, "I do."
0:46:28 > 0:46:30I do.
0:46:30 > 0:46:33"Adriana, I give you my hand and my heart."
0:46:33 > 0:46:36Adriana, I give you my hand and my heart.
0:46:36 > 0:46:38"As I join my life to yours."
0:46:38 > 0:46:40As I join my life to yours.
0:46:40 > 0:46:42- "With this ring..."- With this ring...
0:46:42 > 0:46:45- "..I thee wed."- ..I thee wed.
0:46:45 > 0:46:48"Javier, I give you my hand and my heart."
0:46:48 > 0:46:50Javier, I give you my hand and my heart.
0:46:50 > 0:46:52"As I join my life to yours."
0:46:52 > 0:46:54As I join my life to yours.
0:46:54 > 0:46:56"With this ring...
0:46:56 > 0:46:58"With this ring..."
0:46:58 > 0:46:59With this ring...
0:46:59 > 0:47:01- "..I thee wed."- ..I thee wed.
0:47:01 > 0:47:02"And with all that I am..."
0:47:02 > 0:47:03And with all that I am...
0:47:03 > 0:47:05- "..I cherish you."- ..I cherish you.
0:47:05 > 0:47:07- "And love you."- And I love you.
0:47:07 > 0:47:12It is really a great honour and privilege to pronounce you...
0:47:13 > 0:47:16..husband and wife.
0:47:17 > 0:47:19- Thank you.- Thank you.
0:47:19 > 0:47:21OTHERS CHEER
0:47:24 > 0:47:28Mr and Mrs Javier and Adriana Galvan.
0:47:28 > 0:47:30CHEERING AND APPLAUSE
0:47:38 > 0:47:42Two days after the ceremony, Javier started a new round of chemo.
0:47:44 > 0:47:46He died the following day.
0:47:46 > 0:47:50His end was probably hastened by his treatment,
0:47:50 > 0:47:52but he had also died fighting.
0:47:56 > 0:48:00Though I'd been just a small part of Javier's last days on Earth,
0:48:00 > 0:48:03I couldn't help grieving his loss.
0:48:03 > 0:48:08I realised that for young people who have hopes and dreams, to ask them
0:48:08 > 0:48:13not to take everything on offer to keep going is almost impossible.
0:48:21 > 0:48:23Two months after I first arrived at the hospital,
0:48:23 > 0:48:26I had an extraordinary call.
0:48:26 > 0:48:29In a turn of events the doctors were having trouble explaining,
0:48:29 > 0:48:32Langston's family had got their miracle.
0:48:34 > 0:48:39Hi, Langston, I'm Heather. Do you remember me?
0:48:39 > 0:48:43Langston? Who's this?
0:48:43 > 0:48:44Who's that?
0:48:46 > 0:48:47My sister!
0:48:47 > 0:48:52Oh, my God. Oh, my God!
0:48:56 > 0:49:00Can you tell me who's that? Who's that, Langston?
0:49:00 > 0:49:01My sister.
0:49:01 > 0:49:03Oh, your sister.
0:49:05 > 0:49:09Oh, I'm so happy you're OK.
0:49:09 > 0:49:11I really am so happy.
0:49:11 > 0:49:14Yay! OK, I won't cry.
0:49:15 > 0:49:17Oh, wow!
0:49:21 > 0:49:23Who's that?
0:49:23 > 0:49:25Who's that? His name is Louis.
0:49:25 > 0:49:28We're from the BBC from Britain.
0:49:28 > 0:49:31We've been filming you while you've been ill.
0:49:33 > 0:49:34This is amazing.
0:49:34 > 0:49:37Watch. I love you, Langston.
0:49:38 > 0:49:40I love you, Langston.
0:49:40 > 0:49:42- I love you, too. - See? "I love you too."
0:49:42 > 0:49:44You don't seem that surprised.
0:49:44 > 0:49:47I already told you what was going to happen.
0:49:47 > 0:49:49I'm grateful and I'm thankful to God.
0:49:49 > 0:49:53I knew he was going to be OK and I know he's going to get better.
0:49:53 > 0:49:54Do you believe this was a miracle?
0:49:54 > 0:49:57Yes. He said yes, too.
0:50:03 > 0:50:07So, that was, um, unexpected...
0:50:07 > 0:50:08- Yeah.- ..would you say?
0:50:08 > 0:50:12Yeah, that was really unexpected, so I just called
0:50:12 > 0:50:17one of the neurologists too, er, that I was working with in the ICU
0:50:17 > 0:50:21and he said, "You know, it's like a one in a million."
0:50:21 > 0:50:24To recap, what had originally been said -
0:50:24 > 0:50:27and this is some while ago, a couple of weeks ago now -
0:50:27 > 0:50:30was that the best-case scenario
0:50:30 > 0:50:32- was a vegetative state.- Yes.
0:50:32 > 0:50:37With minimal high brain function, so they said that he would
0:50:37 > 0:50:41basically not follow instructions, not really be a person.
0:50:41 > 0:50:44- Right. Exactly.- And that was the best-case scenario.
0:50:44 > 0:50:47- That was the best-case scenario. - Based on the scans.
0:50:47 > 0:50:50Based on the scans, and what I was told by the neurologist
0:50:50 > 0:50:52and my experience with this,
0:50:52 > 0:50:57so usually if people don't wake up right away, like in a week or so,
0:50:57 > 0:50:59then they don't wake up, so...
0:50:59 > 0:51:03But looking back on it, does that mean you and your colleagues
0:51:03 > 0:51:07made a mistake in this instance, or were you right to...
0:51:07 > 0:51:13manage expectations and base your assessment on the likeliest outcome?
0:51:13 > 0:51:16I guess, you know...
0:51:16 > 0:51:18I think that most people,
0:51:18 > 0:51:23I think it's appropriate to say,
0:51:23 > 0:51:27"This is the best-case scenario based on all the evidence that we have,
0:51:27 > 0:51:31"and based on most patients in this situation,"
0:51:31 > 0:51:33so, er, I think it would...
0:51:33 > 0:51:36It would be inappropriate to give anybody hope
0:51:36 > 0:51:40when the experts - the neuro-intensivists
0:51:40 > 0:51:43and neurologists - are saying there's no chance for a meaningful recovery.
0:51:43 > 0:51:45As we say, they didn't read the textbook.
0:51:45 > 0:51:48He didn't read the textbook - he's supposed to be brain...
0:51:48 > 0:51:51You know, a vegetable, but he's not, he's waking up,
0:51:51 > 0:51:53so that's a miracle, I guess.
0:51:53 > 0:51:55Is it possible he'll make a full recovery?
0:51:55 > 0:51:59I don't know. I really don't know, you know,
0:51:59 > 0:52:02I... God, wouldn't that be great?
0:52:02 > 0:52:05It would make it really hard to have these conversations
0:52:05 > 0:52:06with other families, but, um...
0:52:06 > 0:52:09But I think that would be amazing, yeah.
0:52:09 > 0:52:11Yeah, that would be so exciting.
0:52:37 > 0:52:39I was on my way to see Dontay.
0:52:39 > 0:52:41After five months and ten days in the hospital,
0:52:41 > 0:52:43he'd taken the step of accepting
0:52:43 > 0:52:46that the Cedars-Sinai doctors could do nothing further for him.
0:52:46 > 0:52:48How are you feeling?
0:52:48 > 0:52:50I feel good.
0:52:50 > 0:52:53I put on my... This is the jacket and hat
0:52:53 > 0:52:56I said I was going to wear when I leave out of here -
0:52:56 > 0:52:58it's what I came here in.
0:53:00 > 0:53:04So whatever experience can... You know,
0:53:04 > 0:53:07I can embody and, you know,
0:53:07 > 0:53:10be involved in it and on to the new legacy.
0:53:10 > 0:53:12How is your outlook?
0:53:12 > 0:53:13As far as...?
0:53:13 > 0:53:16General outlook - are you feeling positive?
0:53:16 > 0:53:19Um, I've always been optimistic...
0:53:19 > 0:53:21Um...I'm definitely...
0:53:21 > 0:53:23I think this is a better move for me
0:53:23 > 0:53:28because now I can look for other measures of medications.
0:53:28 > 0:53:32I have, you know, too much life to live.
0:53:32 > 0:53:39I think I can really either beat this or extend the time, at least.
0:53:39 > 0:53:41Hi, Dr Gould.
0:53:41 > 0:53:43Hi, Dontay, how are you?
0:53:43 > 0:53:45Good.
0:53:45 > 0:53:47- Yeah?- Mm-hm.- Are you comfortable?
0:53:47 > 0:53:48Yes.
0:53:48 > 0:53:50Good. Any pain?
0:53:50 > 0:53:52No, not so far.
0:53:52 > 0:53:54No? OK.
0:53:54 > 0:53:55No pain.
0:53:55 > 0:53:58Once you get home, the hospice team is going to be there
0:53:58 > 0:54:01to help take care of you. And like we talked about before,
0:54:01 > 0:54:03I won't be seeing you at home,
0:54:03 > 0:54:05but I'll be talking with the hospice team
0:54:05 > 0:54:07and helping to take care of you with them.
0:54:07 > 0:54:13It's been a pleasure working with you for 100 and how many days?
0:54:13 > 0:54:14Lord have mercy!
0:54:14 > 0:54:17Well, putting it all together, it's probably been around nine months -
0:54:17 > 0:54:19maybe a little longer than that.
0:54:19 > 0:54:21All right, Doctor, see you soon.
0:54:21 > 0:54:24- OK.- Thank you.- Bye, Dontay.- Bye.
0:54:28 > 0:54:34Dontay's been on a journey of acceptance to do with him
0:54:34 > 0:54:38not really wanting to face what's going on, to some extent.
0:54:38 > 0:54:41Do you know where he is on that journey now?
0:54:41 > 0:54:44He's still on that journey towards acceptance.
0:54:44 > 0:54:46He's not quite there yet.
0:54:46 > 0:54:50Today, he was able to talk with me about hospice a little bit.
0:54:50 > 0:54:55It's been difficult for him to look at going home,
0:54:55 > 0:54:57that he's going home on a hospice.
0:54:57 > 0:54:59He's been looking at it a lot as,
0:54:59 > 0:55:01"Well, he's going home, he's leaving the hospital,"
0:55:01 > 0:55:03but not really what that means -
0:55:03 > 0:55:07that it's about taking care of him as he's going through the dying process
0:55:07 > 0:55:09and accepting that he is dying.
0:55:09 > 0:55:12And, er, even now he's still, you know,
0:55:12 > 0:55:14praying and hoping for a miracle.
0:55:14 > 0:55:17Has there ever been a time when you've felt if he had not been
0:55:17 > 0:55:22so, um, keen on beating the cancer
0:55:22 > 0:55:25that he would have not put himself through so much suffering?
0:55:25 > 0:55:26I...
0:55:28 > 0:55:30His strong willpower of wanting to live
0:55:30 > 0:55:35and needing to live and being willing to go through painful procedures
0:55:35 > 0:55:38and interventions that he knew would make him feel worse
0:55:38 > 0:55:42in the short term, that he knew would bring on more pain in the short term,
0:55:42 > 0:55:45for the chance of doing better, for the chance of being better
0:55:45 > 0:55:47afterwards, um...
0:55:47 > 0:55:49Because of that, yes, he did go through more pain
0:55:49 > 0:55:53and more suffering but, you know,
0:55:53 > 0:55:55there's not a right or wrong way
0:55:55 > 0:56:00to do that and it's a very individual decision on whether somebody...
0:56:02 > 0:56:06..is willing to go through that. And for Dontay, it was worth it.
0:56:06 > 0:56:11Right, Mr Rogers. Before we go, if I can just get a quick signature.
0:56:11 > 0:56:14It's just for consent for us to take you back to your aunt's, right?
0:56:14 > 0:56:18- Yes.- All right. Here you go. Just get your signature here.
0:56:47 > 0:56:50Six weeks after he was discharged,
0:56:50 > 0:56:52Dontay died at his Aunt Bonnie's house,
0:56:52 > 0:56:55surrounded by friends and family.
0:56:57 > 0:57:01Oh, my God! Hi, Langston!
0:57:01 > 0:57:03- APPLAUSE - Hi!
0:57:06 > 0:57:08Seven weeks after he woke up,
0:57:08 > 0:57:12after intensive rehabilitation at another facility,
0:57:12 > 0:57:15Langston paid a visit to the ICU.
0:57:15 > 0:57:18- Oh, my gosh!- How you doing? I'm Louis. Nice to meet you properly.
0:57:18 > 0:57:20- Wow!- How are you feeling?- I'm good.
0:57:20 > 0:57:21- You're good?- Yeah.
0:57:21 > 0:57:25These people - everybody is just so excited that you're here.
0:57:25 > 0:57:28We're just... You're a miracle - you know that, right?
0:57:28 > 0:57:29Yeah. Yeah.
0:57:29 > 0:57:31What's the first thing you remember?
0:57:31 > 0:57:34- Er, nothing, really. - You don't remember?- Just waking up.
0:57:34 > 0:57:36Where do you remember waking up?
0:57:36 > 0:57:37At the other hospital.
0:57:37 > 0:57:39At the other hospital? So you don't remember...
0:57:39 > 0:57:42Cos when woke up here it was right before you were about to go,
0:57:42 > 0:57:47and that was amazing just to see that, yeah, yeah.
0:57:47 > 0:57:49- Congratulations.- Thank you.
0:57:49 > 0:57:53- Wow! Do you want to see the room where you were?- Yeah.
0:57:53 > 0:57:54Yeah, come on down.
0:57:54 > 0:57:58There's nobody in there, right?
0:57:58 > 0:58:01These are all the people that took care of you.