A medical team and I were on morning rounds and the whole hospital was buzzing with activity when an announcement coming through the Mayo Clinic sound system: “Code Red — Joseph Wing room 424!”

It stopped everyone in their tracks and for me, as a third-year resident, it was the first time I was the doctor in charge.

We rushed into action, grabbing a crash cart along the way as we raced down the halls toward room 424 — and the patient inside.

Doctors make informed decisions about the end of their lives. New legislation encourages others to do the same.

Flickr: phalinn

Immediately, we got to work.

“Starting compressions.”

“Do we have a pulse?”

“Get the tray ready to intubate and secure the airway”

“Okay, push epinephrine, and get ready to shock him.”

Most doctors make sure not to die in the hospital. We’ve seen these episodes. We’ve been in charge of running a Code Red when someone has stopped breathing or has no pulse. We know it isn’t pretty.

The years of watching other senior residents in command had made me certain of the necessary steps to take, and in what order. It was a well-orchestrated dance of nurses and doctors crowded into a small room around a patient who was in the process of dying.

In that moment, the name of the patient didn’t matter. The diagnosis was secondary. All we knew was this: when Code Red is called, the team acts, doing everything in our power to save the life of the person in front of us.

The scene may seem cinematic, but the drama isn’t as convenient as it is portrayed on TV. There are moments of chaos and then long moments of calm, when everyone waits to see if a patient regains a heartbeat, or wakes up at all. During one of those pauses, nurses say what they know about the patient; why they are here and what they are being treated for.

In that specific case, an elderly man was sick with pneumonia and lung cancer, and the chemotherapy and radiation hadn’t worked. Despite the treatments, his tumor had progressed. He had been receiving antibiotics and the hope was that they would make him healthy enough to try a new combination of drugs.

But after 30 minutes of failing to bring him back, the responsibility was on me to call it. It was 10:24 a.m.

One by one everyone — bystanders and the other staff members who had come to see if they could help — retreated, leaving the remnants of our efforts strewn about the room with gauze, catheter kits, IV lines and more. The patient, draped half in a sheet and with tubes protruding from every orifice, was dead.

During our team debriefing, a 10-minute discussion of what went right and what could be improved in that Code Red, I couldn’t help but think about something. Pneumonia was long ago dubbed the “old man’s friend” because in the old days people usually died from it, peacefully in their sleep. There wasn’t the drama of the CPR, breathing machines and all that. Nor was there the trauma that a flurry of activity can leave behind.

I wondered why would someone as old as this man with a terminal condition want to endure all that when his body was on the verge of naturally giving out? Back then — and this wasn’t really so long ago — we didn’t routinely discuss end-of-life care when someone came to the hospital.

At the time, people presumed that if a patient had discussed end-of-life decisions with their primary care doctors, then the information was written on their medical chart. If not, everything would be done — no matter what — to revive them at the hospital: CPR, breathing machines or whatever else was needed to keep them alive.

Still, it bothered me. Most doctors make sure not to die in the hospital. We’ve seen these episodes. We’ve been in charge of running a Code Red when someone has stopped breathing or has no pulse. We know it isn’t pretty. It doesn’t look at all peaceful or comforting. If there is little chance of survival after a cardiac arrest for someone with a terminal condition, most doctors agree it doesn’t make sense to cause more suffering. And so we know better than to put ourselves through that.

So, why is it different for patients?

Well, for one thing, these are not easy discussions to have. After Sarah Palin dubbed end-of-life discussions related to the Affordable Care Act “death panels” in 2009, there was a huge backlash against discussing such directives with doctors. Several patients have asked me why I want to talk about dying when they are in the office to discuss lowering their cholesterol, or treating their high blood pressure. Their point is that they are there to make sure they live.

And there’s another issue. There is precious little time to have a really thorough conversation about what it means to write or record a living will, or make advanced directives, because there are so many nuances to these decisions, whether personal, religious, ethical or other. We shouldn’t just hand patients a pamphlet and ask them to write down their wishes and send it back to the office later — and yet that’s how it’s done in many offices. This is even sometimes true, sadly, in my own office.

All that is about to change.

The main difference, as a result of passage of this bill, is that Medicare will now pay doctors to lead this conversation — not during a busy appointment while receiving multiple other complaints, but just by itself.

The “Care Act of 2015” is a bipartisan bill introduced by U.S. Sens. Johnny Isakson of Georgia and Mark Warner of Virginia that is designed to give people with serious illnesses the freedom to make informed choices about what care they do and don’t want at the end of their life, and the power to have their decisions honored.

The main difference, as a result of passage of this bill, is that Medicare will now pay doctors to lead this conversation — not during a busy appointment while receiving multiple other complaints, but just by itself. Why? Even the federal government recognizes that it takes more time to have a dialogue about death and dying.

The bill provides Medicare coverage for a patient-centered voluntary discussion of end-of-life choices resulting in the documentation of the individual’s wishes for their care. It also provides resources for public and professional education materials about care planning to be shared with those involved in the process.

The act also provides research funding to evaluate whether individuals’ stated goals, values and preferences in their care plans match the treatment that is delivered in the long term.

Will paying doctors and other members of the health care team to have these discussions actually make a difference? Time will tell, but health care providers will no longer have a financial incentive to talk with patients about their immediate health concerns to the exclusion of end-of-life wishes.

It makes it easier for health care providers to really listen to what a patient has to say about death — often they say, understandably, that they don’t want to suffer in pain at the end of their lives. If they are going to get better, they want their illness to be treated, but if there is no hope of survival, they often want to die peacefully, naturally and without a lot of interventions.

It is a better way to honor the Hippocratic oath, which promises that doctors will “do no harm.”

Putting such wishes in writing can help to take the burden off of family and loved ones to decide if, and when, to take a loved one off of life support. We should all make our wishes known beforehand, rather than waiting until we are too sick to say.

If the elderly man had done that all those years ago, his last moments might not have been so frantic with the hands of residents desperately trying to keep him alive — and failing because his body had already had enough.