Transcripts For DW How 20240702

Most people spend their final days here in a hospital. Although most of us would prefer to die at home. Only very few do. So is there too much end of life treatment . Is not everything thats possible is necessary. So am i acting in this patients interest so it should not be anyone elses interest, and definitely not for economic interests. How much health should we expect from doctors and how much to the patients own wishes count and thoughts in and a patient system most can depending up on life support like 20 years of staring at the ceiling, i dont miss without being able to speak. Im a drama die to have to accept box up in our hospitals actually profiting from end of life treatment. The dying is often a taboo subject. And one with much potential for conflict. The 1st to earth, sasha, its ashes to ashes, dust to dust the around half of the population in germany will take their last breath in a hospital for a better look at death and dying with tubes and ventilator. As weve come to an intensive care when the doctors are on their morning rounds with them all good, good morning. Good. As to how are you . Youre all you have a serious circulation problem in your heart muscle. At the moment, were not happy with how things are looking and this will move, so were going to take care of you a bit longer. Okay, and ill see, ill see i go, why does so many people die in hospital beds and not peacefully at home . Does any ill have to of identity because if you dont either on our rounds, we see very many elderly patients fees and they often have many different illnesses coming done plus, and they still come to hospital. So its kind of caused some of the voting. You try to help them somehow, but as we see in this case, in front of these co morbidities are so extensive, hope a talk that in conjunction with the results we got yesterday on the home phone on there is not a lot you can do. Thats fine. Even though its influenced, hasnt come over young since wants to switch to Palliative Care, preparing one for end of life. Would like so many peoples a man hasnt loved to patients decree, young since tries without success, to reach the mans relatives, to find out how much more treatment the man should be given. This is something that i spend about 2 hours a day on the phone. It feels like, because i think its important to talk to the gps, but its incredibly difficult for us. Hold on or should we have so he has a serious non treatable coronary heart condition of a f one. Uh huh. And and yes. So thats why its uh, that was really very important. Most intensive, the doctor knows him well. He also told the gp that if there were to be great complications, he didnt want to be put in intensive care. But thats important because now we have a clear path to take, even if it wasnt specifically written out. And was this deal for dorothy. It means that we wont be able to help him stay alive. But well try to ensure that he can depart this world peacefully. And painlessly send the tribal amend wilks. Ill take the backpack. I dont know whether its down there. Im going downstairs. Okay. But life threatening situations on the intensive care. We arent always the slow and steady intensive care medic, elise neu, decker is on her way to an emergency one floor down. A woman has been recessive, dated, and needs to be taken to intensive care. Now for further treatment, its unclear whether shell survive the system and then again quickly once in intensive care, shes immediately attached to every live sustaining machine possible. Of course, medics want to hear people like many who come to the intensive care unit dont survive. The 20 minutes have passed the least. Could you describe whats happening . So asked me push buttons in this in ask updates of is a patient has been on a heart catheter. They did everything they could to help her, but unfortunately nothing was working and she died again, were waiting for the family. Now its what was important to us for the last step. Thats what it was that we were able to be with that patient. Make sure she had no pain or fear to kinda august of to see me to come in to ok. We were with her by and were holding her hand at the last minute because we were the only ones here and for, for the relatives were still on their way here a lot of money until they can send up until the next patients coming to intensive care are getting older and older to austin. Theyre already sick with many illnesses that prevent them from recovering. Its been up to the doctors to decide if and how long to prolong life does if it is. If we took a normal, sean of intensive care allows enormous opportunities, but also risks bringing that together requires cultural understanding them team as a team. You have to keep finding ways to help the patient have a dignified test and all, and also to accept that death and dying is also part of a therapeutic process. Have a fortune, puts us as a modern medicine often means the process of dying can be very drawn out. It often leaves doctors to make the decision on when to continue treatment. And when to let someone die moving on, since hes on his way to a meeting with the ethics commission. This is where experts from various disciplines convene to decide on whether or not to withdraw life prolonging measures. Today the commission is discussing the fate of a gravely ill lung patient. Hes been in intensive care for several weeks. Hes been kept alive on a ventilator deep behind because of his deteriorating ability to freeze treatments requires ventilation. He is experiencing different phases of infection infections. Thats all healing phases of wakefulness and of confusion and cookies out his physical limits every day. Would you like to add anything between booking a task of selfish data on so were really just trying malta and this future is not looking much better because we dont cnn. Okay. And thats the question was, was it a viscous series to assess the fargo . How much longer can we continue doing this . Its not, wheres the and what is all call input . Lets at least one of us may have been looking for satellite. Weve already been trying and for a long time to get them off the ventilator. We keep reaching the 4 hour mark tournament by continuous spontaneous breathing has failed the several times, most the most glue that has ever missed. The risk is so great. If we took them off, you would certainly suffer oregon failure. Send them an authority to stays on the ventilator must then come, then he will continue to live rust from what is known about his wishes, which for treatment in his ive never really made any explicit statements that see that. So we dont have any exact information of the patients wishes under the impulse hadnt been so many as long ago. Its nice and would value for saying he can be taken off the ventilator long. Then were looking at a long term, permanent dependence on a ventilator either at home or somewhere out to the asthma, all. And then how is that something his family can perceive for him or not, or so. And how does this, though, is does all of a sudden want to know his wishes to go home, but i dont see it as a viable option. Every few days we take a step backward carter of the dentist with simple kids. The patient becomes full of mucus, again, slight gets really distressed, which uses up all his energy and one week i dont see that being any different at home as well. Thank you for holding this. Im assign the size water that informs now what that means, that fulfilling his wish to go home and which means hes on the ventilator. Its one in 24 hour intensive castle, and that would make things difficult for his families. And so to 250. 00, from here it is on order. Thank office. On the how is it for the yes, i agree. If we can transfer mr. A back home, it would be purely palliative edition all the way mr. A sees it. However, hes not seeing himself as bed bound, i would have supposed to be on this, but there is no alternative. He cannot move freely side when hes think of it, thats i think that were talking about a palliative scenario. Question this way. We will, in accordance with his wishes, send him home, but i dont think it could be for a long time. These are good and use beam for citing pastoral catch of the family and patient for a long time. So theres lots of teamwork, guidance, and all that kind of the kinds of slaves they did speak extensively about the end of his life, from a religious point of view of him with a zip for the other. His wife couldnt imagine turning the home into an intensive care room, as if which is what being put on a ventilator at home means. When somebody does, he just wants to hold on and process. Instead, she told me that in her view that we should stand humbly at the end of our lives and be thankful for the long time they had together. Since we discussed that in the last few days. Thats not a strong team. I. Yes. And then thats in time, as far as induce, that means miss commission has decided that that should be a transition to Palliative Care to the relatives have to be informed on the ongoing cool. Do that informed me . Okay. Awesome. Youll definitely have to deal with that. The next time you speak age, thank you. Your style, gosh, not every hospital has such an ethics commission. Youll see it in here about element. Were discussing ethical decisions that are not of a medical nature, but that concern us as humans. The name of these are still 2400. 00 and we believe that if such a structure is not in place. So then it should be mandatory listed as irish physicians that we have left the decision of her life and death in the hands of the doctors. I wonder why is it so unusual for people to die . A natural death at home . If on it, so im not going to visit janelle to the patient now, but they have been issue. Ive been involved in the cast since last week talking to me because she was having serious breathing problem was actually a little skilled, unfair that in my mind had 1st they kept calling me. Im going to say i sunday, but now she doesnt want to go to hospitals because she knows if she calls and im good on life and then shell end up in the clinic and gets him as a fund any cleaning. But he is turns is an anesthesiologist and palliative medic, he visits terminally ill or dying people where theyve chosen to die at home, surrounded by their families. Hello, good afternoon. Its going to be like toys. Nope. Ill head straight through. Hello everyone. Hello, hello. Contact. Hi lou. Traffic your systems, we dont, ill sit down here again. Perfect, perfect. As im asking visuals, landsey my 1st visit was you were very anxious because someone at the clinic i told you you were dying. The is this in the knowledge that felt since youve been home to let some tag offer shop for . No, im not scanned. And havent had anything untoward. Any thoughts that might trouble mainly saved and when did you have as many praising episodes in the past . Few die in the off they stopped coming altogether, middle of the table. No, no more shortness of breath. I would ask you havent noticed anything, have you . No, no god, im amazed that has been going so well and wondered what you say. And i feel as though your and your best bet today, im no, no, no. No. Obviously didnt applaud you mind to 5. Listen. Lean forward and 4. Perfect, perfect. Teeth. 100 and a deep breath in and out of these black dish to stay in the house. Shes basically come home to die. Thats the blunt way of putting as he does so both her and us. Its how pursuit auction i can use. We can enjoy the time we have left on and its nice having mama here in cindy is best buy on a marketing point. All have to face this some time or rather, to be honest, so it doesnt bother me. Honestly. Yeah. Maybe im the exception. Ive seen something because im different, my mothers youngest being older. I dont know how other people take it. Temperature, ive no idea how others deal with with knowing they are going to die in the next few days. Ive order for life next, but i think its all totally natural stuff. These concepts. Huge. Yeah. So its a strange situation there perhaps for you more than me. But i dont mind. My worry is that it happens late, not young. Im not into concrete. C a n plus huts im im, im not listening but i know is it right . Yeah, i can help her immediately as a practice. She oh look forward to your varner this afternoon. The potential, hows of we want to ensure the top patients are doing well a on autumn to make himself a breathing programs. I know nausea or vomiting any time. And then this mentioned excellent. Com be helpful home. Yeah. And the only place is the clean energy cleaning cap and the about. So how is the best, how you can be treated at home, and then people stay at home done, and lab dimensions. So hows most problems can be resolved through simple medication. Me to come in and we only have 7 different medicines, and our Emergency Box is on the front, but you can treat 20 problems of outpatient itself within a half months. That basically giving instructions on the fine example of tabi. So hows the losing inputs of telephone i live. Okay. And if you have any problems get in touch. Otherwise ill see you again next week. Cool the best im still a step ahead of the grim reaper. I still have a little time left. Its the thats funny. Im a visa. Yeah. Puts in. When did you see how much of patients who come home again tend to flourish and you know, shes practically just been discharged from a hospital, death bed and utilities. So she looks like shes going to die and the next few days down the country up this week, shes dramatically improved on the about what else have to patient has no, i die puts in a deal with the to every day. So to the, just the lights on minutes company and people at the end of their lives to take is a relatively fulfilling organization thing. Because you often managed a severe pain or breathing difficulties. This kind of cost icons safe. My patients lives to feed them or not, but for many of them, the total death is no longer the enemy. And the sudden def, i managed to ensure that i have a painless Processing System is that is a good thing. Lets go to the 92 year old in a mountain, died a month later, at home, as she had wanted. But how can one ensure that youre the one who decides how you dine the weve heard from a former intensive care worker. She says she would never want to be recessive, stated the high a. Its for the so youve taken steps to ensure that if the paramedic comes and youre unconscious that you wouldnt be recessive hated, is that right . And whatever, you know, only if my heart keeps out when done, and when the paramedics arrives to them and they send it to when the door closes, see that, that close the screen stick a note, theres an emergency buckle that on the emergency. Barclays in the fridge, then gate then decreases. They go to the kitchen. And when they open the door, hear the best, the bottle. And whats in there . The doors this and theres a document with lots of patient information in info, not feeling this thats good, okay. And here, once he written in big red, let us do not for such a date and why dont you want that . Well, ive seen too many things back when i was working a simple you mean you wouldnt want to be taken to the hospital then . It was, i didnt want to go to a hospital and i didnt want to be put on a ventilator ok to life by groups. The who knows how long its always been for the that the 89 year old is familiar with the procedures on intensive care stations. Is this does or does it have, do you have the feeling that just too much is done to keep people alive . The people arent allowed to die. Yeah. And they will mental mind this. Yes. Comes from the moment you arrive in the hospital system. No, its like hit the paramedics, the ash the dont exist in cameras. Have to do everything and the power to keep me in line after the 1st he does have for substitute aged May Institute for me with that. So then thats exactly what i dont want to spend the 70 but here what was it that you experienced that made you say, no, i do not want that to happen. To me it says will lead 17 nasa live test, but thats in the i often so elderly people being resale so tiny take yeah. Even then they will put you on i these are the ones that happened. Ventilation was 12 and finally dying on days, weeks. Lets months later talking, and i dont think you need that or visit site. So i want to know if my life the way i want until the end. Thats the one i can no longer do that just makes me has been not should be the end of it to end again. The, its rare to day that people are in control of their lives at the end of life. Will the former nurse get her wish will she and chandra paramedics so wouldnt recessive teacher in such a scenario . The, the 89 year old fears that she might end up like this patient, this terminally ill cancer patient is on live support in a coma. After being recessive, hated after his heart stopped intensive care nurse at least knowing decker is looking after him. Im just going to check something, dont worry to his kidney and deliver it have already failed. And his brain is barely functioning. Thats it. And then we dont believe licensed also who patients are resuscitated, usually outside their homes, workforce digits. They arrive here and are given every medical treatment possible calls. And then you find out like in this case that the brain is had too little oxygen during resuscitation. For though we often see patients not wake up and then its days or weeks before instrumental diagnostics to tell us that theyre actually not able to wake up again, let me do a pop up to you. Theres no sticks in. Their brains are so terribly damaged to us that we cant help them. So events associated with this with input sentence here, mission the hudson code and this 58 year old is also not going to wake up a lease is giving him Palliative Care and will accompany him as he dies system ive got everything ready. The, do you always talk to your patients . Yeah, yes. Right. Because i always assume that they can perhaps still hear something to we always do our best, especially for patients who are dying. So can you always respect your patient that affects what inputs and the mind has so what usually happens when doctors go from trying to save someones life to recognizing they will dine, then giving them its an ongoing for them to not leave me to come, we accompany Family Members into the room, the medication has already been swap to hide those pain killers and so, and other medication to protect the patient to ensure theyre not in distress. And then we switch off life support option. We always wait a little moment to him and dr. Young relatives have to adjust to the situation, so its always hard to sit next to the bed and comprehend your Family Member is about to die. One of the most frequent questions that relatives ask me is how long will it take . Of their always scared. It will happen right away above it varies from patient to patient, but usually it takes around 2 days. But that is a very long time, central 12 days. So and then the patient dies because theyre already very weak and also not going to come to the phone for your account. And the terminally ill patient in room 3 has no relatives here to sit with him. And while death is part of the daily conversation here at the hospital in our society, it has increasingly become a taboo. The missile jones out of town suff default or send them via us because this off so we really need to seriously ask ourselves as a society what we want from the store and what we dont want in my experience in so i often meet relatives and patients and intensive care and them are the who are still surprised in that at 8590 the 92 years old, the present and theyve reached a period of life where you have to consider its and one to show us more. The one, the thing content assess, leaving english is but modern medicine has also failed to sufficiently keep up with the growing age of people. There are few fully qualified palliative medics on intensive care wings. Instead, many people face lengthy and invasive forms of treatment. Sometimes this is because the doctor isnt sure what to do, but also sometimes because of the financial benefit, there is much money that can be made by implementing these complex end of life procedures. Issues this feed, advise us and put cents into its much easier as a doctor to intimate a patient of us to give them oxygen and a few odd to resuscitate them. Replace their kidney with this. Of them have this critical discussion about whether were genuinely doing the right thing for the patient. Our only responsibility is to the patient lesson for not to anyone else. We need to assess this in and when some fields of medicine become more interested in making money based on the overheads, not officially and explicit links, then medicine is on a very rocky road start in the good. See man on the side. Got him. Thats whats been happening for the past 20 years and us and sponsor shawn. So 1st how can it be that people end up being treated in a hospital against their will for financial profit . Usually we assume doctors are there to help us at the end of our lives, the but defying the will of the doctor can be incredibly difficult and painful. Like for helmet lender, whos fighting for doctors to allow his wife to dine in peace of mind. Fold people here. Associates 6, this is my wife in t hold. That picture is 6 years old. Now lets look at her hair. Shes 68 now, and this is what she looks like and this stuff. Its awful. I want to save her from ending up lying there miserably, even prophetically. She wont leave. I owe that to her usual. Its such a long time. Yeah. Yes. Intensive care for 3 months to shes been there since august 12th. Shes had 18 operations here. Inglewood lender went to the hospital 5 months ago for back opperation, where she became infected with a super buck. Despite several operations, doctors havent been able to defeat it means the separated the blue. I have got the picture showing what she looks like. Now. You can see on permanent life, oh, poor, have moved a respirator and intravenous vig was a nimble 4 months ago. Helmets wifes heart stopped since then. Shes been on live support and in a coma. Neurological tests suggest that theres little likelihood of improvement. Shed already put her wishes down in a plan for treatment the most to advertisement. I just want to make sure her will is followed heavy advice. War to her that she wouldnt end up on machines for years in a home somewhere, just lying there, thats up to me. She doesnt deserve that. And she doesnt want it. You dont mind can. You can go through all these points, those never pages of them as everythings there. In the case of brain damage, untreatable, illness, near death. Its all there and on, and brain shutting down. Its all written down exactly what they are ignoring at all. I tell them read it, its all there. Its but we just go round in circles and keep coming back to the same point of think life and pulled on. Does i know and listens to you even though you have power of attorney . I mean, no, no, not at all. Thats weir, ignore you. All you hear is we decide what happened be. Thats how it is in germany. It doesnt matter how many people come with their treatment plan. We have to perform any treatment we can before. If anything else is youth an age of p of i say, what exactly is it then that youre doing thats on demand or when i say i just want it to end . So we get to the box. Lets hear helmets. Health Insurance Company has helped him find a medical expert for a 2nd professional opinion. Its hope that theyll help to finally carry out the wishes of his wife. Im fixing go toolbar, vice tibbetts by your i was with her last on october 6th for it was the day before the altar perforated in her heart stop. Will you have to on hatch this done . On down below, we are religious people and we always spoke about those things. Awesome. And we said goodbye once for us and wed see each other and it turned a deal. She said she was ready to go and advise if she said she was going, i said, dont say that. She said, yes, you know, i am, give me kansas city. I had just given her some yogurt. And thats how it went done this stuff. So yeah, its hard to, theyre really hard who must see me. Its on the whole scheme in a weeks time, how much lender has another meeting at the hospital for hours away. He hopes the doctors will give in after the experts report and start giving his wife Palliative Care. This is the statement we got from the hospital. In the event of regaining consciousness, there is a possibility that mrs. Linda could breeze on her own and at least partial physical rehabilitation. Although a temporary or permanent need for life support measures cannot be ruled out as such, because the situation is not mentioned specifically in the patients preferred treatment plan. And recovery cannot be ruled out. Medical steps have been taken thus far. So the patients assumed wishes could be determined the how can seriously ill people be sure their wishes are carried out. The Palliative Care doctor not to use terms, is the author of the report on mrs. Lenders case. Hes to decide whether or not the doctor should hes the wishes of the 68 year old. Much he is turns dedicates himself to dignified dying, not to the interest of business, and such disputes make him sad and angry. Mrs lenders, case is not an exception. I think assigned to puts it in fact who will increase this being. In fact, a patients preferred treatment plan is legally binding intact with that, but thats not subscribed for interpretation. Sometimes the boundaries are pushed on, treatment continues the month on like the patient obviously doesnt ones that often cuz i failed to ask what the outcome of treatment to be in a peak is what someone wishes to be the outcome. Actually the goal of the treatment, which is the zip, isnt even the chief of all the highs and often, even if i can, this guy isnt, doesnt, its on the chief of all high of the vitality of the treatment. Is that something that really bothers me and my, well, the last one of the decision should have been taking a lot of the, a few for the provision of appropriate palliative cap on the a, t f. As on the homeless who monitors what the doctors are doing, whats the legal situation in germany . The puts and Partner Law Firm is specialized in end of life legislation. They deal on an almost daily basis with cases that focus on the will of the patient and how to best implemented going types of just that was consistent as much as you basically, our friends begins with the views at any medical intervention, including those that for long life, even if its a ventilator, its physically invasive. Im because it has to be justified by the media and an intervention is only justified. And its when there is a medical reason for it to a small end to an agreement by the patient, or thats just not as the last name if there is no reason for medical intervention because it would cause more harm than good. If its causing something more distress, then being able to achieve a sensible go into cups, then things change life or then what is being carried out is and then legal assault. I think it is a crime. However, the federal prosecutor will usually not convict adult to for prolonging life. They always seek a way to avoid that, and i will speak simplified and to full. Tanya owner has seen repeated cases in which doctors are uncertain and over treat their patients because of it. But shes also seen them act out of financial interest on common things that as the one on the legal path. If the doctor was suspected of acting solely out of financial gain on which up to one behind them loosen f as it is a fast released on this list. Suspicion is a blue waist lingering in the room, but its hard to enforce the nor on the basis of the current legislation. Because you have to prove that the assault was committed intentionally. I remember full financial gain and them to if you have the relatives would become the tradition. If they say their relative has been allowed to suffer from their distress as being per learned only for the dont use it to make money and funding. You have the chance of getting a 2nd opinion, obviously not totally sure what the lucas preferably from adult to, to has nothing to gain from this treatment to the other mist under a 150. And the fact is that in the future will lead more doctors who are familiar with Palliative Care and take a more critical approach to their work. Which one is the winner here . Ethics or economics, human or machine helmet lender has driven 4 hours from his home and lower sacks and the to the clinic. He wants one more talk with the doctors to convince them to heed the will of his wife and allow her to die views most. So young will not know if shes been lying in this hospital for 4 months and intensive care. Itd be cool with just to the thought of it is terrible. Its just like like, i mean, ive made an appointment and im going there now. When cool. Im fighting for my wifes rights. Yeah. They do it because its through. Its a terrible injustice. Whats happening today because its hard to thats why ive come expressly to tell these doctors that took her to the mice. Hes an absences arden for 4 months. The doctors have refused to follow the wishes of their patient english lender. Its going to be a long and hard discussion between helmet lender and the doctors because theres been no agreement so far. A local judge has been brought in. Shes due to rule to dance. What she believes, so the wishes of english lender 4 hours later up to the phone with us, im delighted of by the tv, this one. So with the media, the fact the Palliative Care is going to begin it. That Means Nothing to stop her from dying, and its been a long battle for a very, very sad thing for you on. But i had to do it. And im glad i did this. I feel a sense of relief now. Yeah. Yeah, theres a deep grief. But also relief with teacher tall. I will feel like the child is walking as editing this month. She adds to mines in this, its very alarming how some doctors think they have to apply every possible medical application. Every time ive got the assessment on the job as talk to as far as adults, just to have to ask yourself, what is the goal of the treatment . Nice. And then what can we achieve for the patient to attend . And if we cannot achieve the patients recovery or a best fight, will only leave them on life support and stuff, and thats not something the individual patient would have wished for themselves, the 100 project to attend. And then we have the doctors have to accept that the goal of treating them is unobtainable to stay on. The goal must change hygiene. When can the worst case scenario, except to allow that patients to die interest them. Lets say what does the humane desk look like . When the patient is not at home. No. Are you still in touch . Good friends. When i see a patient like that it really makes my heart ache. Its all just cool. Mm hm. At least knowing deckers patient has suddenly deteriorated today. His breathing was difficulty, caring for him in this condition isnt easy. The cuts in good yesterday, his breathing was so stable that we decided to remove his ventilation to huntington. The awesome show house of 10 and we reduce the medication that was helping him sleep in himself, hudson, 100 of my own type of shows to food. Now im in a dilemma of some of the cities, very distressed. Instead of stressed with us. And ive had to call the doctors and started giving in the sleep medication again and just dont know buying and having 5 issues or not because i dont wanna leave him like that. So what it says is really a distress. This is kind of heart rate of label at least wait for the lead doctor to come and help me. It says, oh my god, i know now im treading a fine line in the light. Most of you is not to, i dont want my patients to be so distressed me. So wish test is, but i dont want him to die because of what im giving him stuff on for philip. Lets because hes no longer on a ventilator which made the ultimate is assessed. This helped us before i am taking it really slowly on understand. So theres often a very sin line between accompanying someone at the end of life and assisting them in at the doctor can ease the situation for the patient by changing the medication. Thats honest and misleading. Come in, we should manage the symptoms now with medication for success. The most important thing for you to are in for this treatment is end of life care with symptom management. And the patients breathing is back under control. The process of dying slowly moves on. This is the motive for the initial and focus, so its on the phone. Its always my personal aim to do things i would want done for me. It would have been if me or a member of my family were lying there. I was just a, its a dream job for you, isnt it w . Thats my told it is my dream job, my absolute dream job to at home. I couldnt imagine doing anything else and it was flushed as a lease, as patient donna is later that evening. The, its english lenders funeral. She dies 5 days after her treatment was switched to end of life care at the hospital. You should have almost got to come. Ive been level for i have to find a piece now. But im glad that with a lot of help, i managed to see her last wish, realized it. But we have our faith and faith helps a lot on deck. Love with the stop by. And i will be able to find my own way and carry on somehow, and one of the good lord shall bless your farewell under rival notice and forever more than the last. So special about this is this staple feed from, donna, is made from time chains and cassava. And yeah, and its amazing with lots of different things, i think mostly in the afternoons. So thats by evening suggestion, we have to can please follow us on the calendar and see how the country instead of breaks the same mistake of feedback in 30 minutes dw, the get ready for an exciting. Ive been trying to look surprised. Hi, irish. And im ready to dive into the hands of children to which you have you have a one, the front porch response and the unexpected side to side. Mars around the block. And then just to see a quote, you can make sure sure go you for use your sisters have been in a coma that was caused by persecution and flight for con dreams of another world. The boss, the dots june sized d w. The, this is dw, can use life from violin. Hostage talks between israel and how much a do you to restock next week. But it is what it allows to continue. Its fight against comma and more details in the to of an operation in northern ga. So thats forcing even more palestinians to sleep. Also coming up, the heat is on them, the political raise will the capital denny, as india reaches the final stretch of virus on elections, to pick new leaders and the 77th comm Film Festival doors to a close drama about the next dont take done. So wins the top prize, the pound or