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Helpless as companion dies

State law allows estranged daughter to decide woman's fate

Joe John Sorce never thought it would end this way. In a hospital room with his longtime companion, Mary Clark, as she took her last breaths. He, holding her hand, unable to do anything about it.

"I felt so helpless," he said. "I couldn't believe I didn't have anything to say about this. I said, 'Mary, don't die on me, please.'"


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  • These days, Sorce paces the room of his cramped Swenson Street apartment. He frets about bills he has received from doctors. He didn't have a voice in her care, "but they want me to pay the bills?"

    The 63-year-old Sorce in recent weeks had fought to keep the woman he calls "my wife of 18 years" on life support at the hospital.

    Before she died, a battle would wage over who would decide when Clark would be removed from life support and who would decide, Sorce or Clark's estranged children.

    What ensued exemplifies the uneasy reality of end-of-life concerns: the legal, medical, ethical and moral issues that burst into the national consciousness during court battles between the husband and parents of Terri Schiavo, the Florida woman who remained in a vegetative state for 15 years before life support was finally disconnected.

    Clark, 53, suffered a stroke Oct. 19 as she and Sorce watched a baseball playoff game between the Tampa Bay Rays and the Boston Red Sox at the El Cortez.

    Paramedics took Clark to Valley Hospital, where Sorce signed her in and where she remained in the emergency room for three days.

    "They said it was too crowded then to get her into intensive care," Sorce recalled. "It was difficult, but Mary was responding to me by squeezing my hand and opening her eyes and looking at me, so I know she was hanging in there. And the medical staff was treating me like I had a role in her life."

    That all changed, he said, when she was taken to intensive care.

    Because Nevada doesn't honor what Sorce said was a common law marriage, doctors and nurses told Sorce he could play no role in medical decisions on her behalf.

    Instead, medical authorities twice consulted with the woman's estranged daughter on whether to take her off life support.

    Clark's daughter, Morgan Miller, said a Valley doctor told her on two occasions that her mother was "terminal" and that there was no hope. Miller said that's why she gave permission for her mother to be withdrawn from life support.

    The first time she gave permission was Oct. 29. It was the same day that Sorce's attorney had gone over to the hospital.

    "I asked them (hospital officials) not to take any action on that day, because I was going to file a petition for guardianship for Mr. Sorce," said Marina Kolias, who Sorce had hired in an attempt to get him named as Clark's guardian.

    Kolias said she received an emotional phone call later the same day from Sorce, who was visiting Clark at the hospital. He told Kolias that Clark had been withdrawn from life support.

    "Apparently right after I left their office, they talked with Morgan Miller to take Mary Clark off life support," Kolias said. "What was the big rush? That seems ethically and morally corrupt to me. They disrespected Mr. Sorce and they disrespected me. I was crying."

    Kolias said after she learned of Valley's action she rushed to the courthouse and was able to get an Oct. 30 emergency hearing before Clark County Guardianship Commissioner Jon Norheim. He ordered that Clark be put back on life support, allowing Kolias to get a second opinion on Clark's health.

    At a subsequent Nov. 5 court guardianship hearing, Kolias produced an affidavit from Dr. Michael Karagiozis, a physician who had reviewed medical records.

    Though Karagiozis said Clark had suffered a "significant intracranial vascular accident (stroke)," the medical documentation "clearly indicates her condition is improving, is not stationary, and that she possesses some level of consciousness which is sufficient enough to follow simple commands.

    "Mary Clark is not brain dead by any clinical definition. ... It would be premature in the extreme to withdraw essential life support from a conscious patient with some potential for spontaneous improvement."

    Norheim granted a "temporary special limited guardianship" to Sorce following that hearing, allowing him access to Clark's medical providers. But he refused to give Sorce the authority to make any medical decisions on Clark's behalf.

    "The judge followed the law," Kolias said. "He was fair. Unfortunately, Mr. Sorce had no legal standing in Nevada."

    Nevada law defines a terminal condition as "an incurable and irreversible condition that, without the administration of life-sustaining treatment, will, in the opinion of the attending physician, result in death within a relatively short time."

    And if a person determined to be in terminal condition by the attending physician has not made a declaration regarding life-sustaining treatment, the physician is to consult first with the spouse of the patient. If there is not one, adult children will be contacted.

    Sorce is dismayed that Clark's daughter was the one into whose hands the decision was placed.

    "Her daughter didn't care whether she lived or died," Sorce said.

    In a brief phone conversation from her New Mexico home, Miller said she had "no relationship" with her mother, who she said left her as a young child.

    Josh Miller, Clark's son, said he allowed his sister to make the decision. "She told me that doctors said there was no hope for my mother," he said. "I think that's pretty clear."

    In a phone call from his Massachusetts home, he too said he had no relationship with his mother.

    "My parents divorced when I was young, and I didn't see her," he said. "If this Sorce guy loved my mother so much, why didn't he marry her?"

    According to Sorce, the only reason he and Clark did not marry was because of her earlier divorce.

    "She thought it might change our relationship into something bad," he said.

    Sorce said they met while waiting for a bus in Escondido, Calif. "One of our big first dates was Disneyland."

    He and Clark, both telemarketers, went everywhere in Las Vegas by bus.

    They arrived in Las Vegas from California within the past year; neither has health insurance.

    Valley Hospital spokeswoman Gretchen Pappas said a patient is only taken off life support when judged terminally ill by a physician and after consultation with a relative.

    Teri Nolan, the hospital's administrative director of patient safety and regulatory affairs, said Valley officials always follow appropriate legal guidelines.

    Sorce said he received word in the late afternoon of Nov. 19 that hospital officials had again received permission from Clark's daughter to withdraw life support.

    "I received a phone call from Mr. Sorce that evening about this, but there was really nothing more we could do legally," Kolias said.

    Clark died early on Nov. 20.

    Though she is critical of the hospital, Kolias acknowledges that the letter of the law has been followed.

    As for the doctor who offered his expert opinion for Sorce, he says of Clark: "I obviously don't know what shape she was in on Nov. 19. I didn't examine her then."

    As an outgrowth of the case, Kolias said she has become a firmer advocate of people making living wills designating their wishes regarding end-of-life situations.

    "I hate to see anyone go through the kind of heartbreak Mr. Sorce has," she said.

    Pappas and Nolan point out that a living will, or advanced directive, can be prepared for free.

    Pappas said people who are interested can go to www.livingwillockbox.com and fill one out. It's a simple three-step process that only takes a few minutes.

    The Valley Health System and other hospital systems have paperwork that serve the same function.

    "You need to make sure you and your loved ones' wishes are clear to everyone," said Pappas, adding that too often people find themselves in an uncomfortable situation that could have been prevented by a just a little foresight.

    Sorce wishes he and Clark had thought about such matters.

    "We were both feeling well and didn't see something like this coming. But people either have to get legal documents drawn up or get married."

    Sorce does have some say in the aftermath of Clark's death.

    He is in charge of taking care of her remains as per Clark's wishes. But he finds that he doesn't have the financial means to give her the burial she wanted.

    Receiving bills for her care right now "seems like rubbing salt in the wound."

    Kolias believes the bills started going to Sorce because he signed Clark in at the emergency room and it was just assumed he was her husband.

    Valley's Pappas agrees that any medical bills going to Sorce are just an administrative error.

    Sorce doesn't want anybody to go through what he has.

    "When you really love somebody, you should be the one who has the say about life support," he said, choking back tears. "I'll never forget how when they took it off the last time, how she started gasping for breath. I felt so helpless."

    Contact reporter Paul Harasim at pharasim@reviewjournal.com or 702-387-2908.

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    Andre Lagomarsino wrote on January 21, 2009 05:21 PM: Why was Ms. Clark's personal driver's license information (including home, address, birth date, and driver's license number) published in this story?


    C Barb wrote on December 15, 2008 10:06 AM: sad, strokes are so bad. one way or another, no matter how rich one is this happens.
    I think shooting her in the head would be more humane than starvation; the law is wrong.
    They need to change the law or find doctors who have a mortal soul.
    Las Vegas is a very dangerous place to get sick in.


    Che Jones wrote on December 15, 2008 12:55 AM: No sir the proverbial "salt in the wound" is the inconsiderate lack of compassion in between the lines of the comments left by some of the readers of this article. It's pathetic! During the Holidays none the less, I'd hate to imagine what you people are like during the rest of the year. After all, the holidays are when were more caring and compassionate, right?


    Sad Summerlin wrote on December 14, 2008 05:12 PM: Very sad story that could have been likely avoidable with some documentation either via living will or marriage... but that did not happen and thus problems developed.

    Buck - you are absolutely right... I wonder how many people posting below would have had a different opinion if it was a MS. Source and it was two women who had lived together as partners for 18 years and were legally prevented from marriage by State laws.

    In the case where people are "partnered" and not "married", there are few inexpensive means to be granted the same "rights" as those who are "married". 18 years together is a long time... at least Mr. Source was allowed to hold her hand as she passed. Think of the thousands of couples who are denied that right just because their relationship isn't "approved" by society.


    Two Cents wrote on December 14, 2008 02:42 PM: My parents who are now both deceased told me from an early age that they were never, never to be on life support. Period! Take them off. What we have here is either a lack of communication or serious denial about death and dying which we all will do someday. A living will would have been helpful. Being that these people arrived "off the bus" from LA says something about the lack of communication with family. Personally, I am not for leaving terminally ill people on life support to prolong suffering. It is not killing them. What did people do before this technology was invented? A little pre-planning on this couple's part such as getting married would have prevented this from happening. Sad Story. Hope all of us reading this are planning for when we are ready to go so it is not all left to our loved ones. Her children did no wrong. We also do not have this story in more detail concerning the children and her relationship with them. I hope Mr. Sorce can move on. The bills are not his responsibility.


    Klaatu wrote on December 14, 2008 02:42 PM: Here is a win/win situation: whoever has the final word, should donate this woman's body to scientific study, as another poster suggested. The recipient school will pay for funeral costs & students learn an invaluable lession: what would cause a stroke in a 4'10", 225 lb woman.

    I have no earthly clue....


    ET wrote on December 14, 2008 12:46 PM: Why is it ,people without money or insurance what free medical care,live forever ,while those with insurance see the end, and call it a day ?We feel for the folks showing up on the Bus from LA,with there baggage and expect the world to take care of them,she probably was a smoker leading too a stroke at a young age.How would you feel,forgot all about Moma ,then,one day you get the call about her death.We can use her body at the medical Schools,they always need cadavers.Oh,yea,get married and go to www.livingwillockbox.com and check it out.No computer go to library they can help.


    To Cassie wrote on December 14, 2008 12:31 PM: Who are you to this situation? This information in your post that Sorce had no documentation they lived together for 18 years is no where in the article? That they had "no proof they had any 'meaningful relationship." Where did you get this information? I would really like to know.


    Cassie wrote on December 14, 2008 12:21 PM: How is Nevada to recognize this as a common law marriage?? He has no documentation that they were "together" for 18 years or what ever. He could have met her a week before her stroke.
    If the patient came in alert and oriented and declared that she wanted Mr. Source to be her "next of kin" the hospital workers would have moved to make this happen. Look at her state ID. It doesn't even have his address. So, consequently, he has no proof they live together. He has no proof that they had any "meaningful" relationship or that she would have wanted him to be her "spokesperson" if she were incapacitated.
    This case is sad. But, again, it spells out the need for living wills and durable power of attorney paper work being completed.
    The laws are slightly different, but, very similar state to state.


    JL wrote on December 14, 2008 12:06 PM: I'm unsure why Norheim would not grant guardianship to Sorce as I suspect the adult children would not object. Guardianships of someone so clearly incompetent should not be so difficult to obtain.

    Morgan Miller should never have accepted the responsibility of making such a decision. She and her brother are clearly bitter (and they may have good reasons for being so) and incapable of making a rational decision.

    Every person, legally married or not, should have both a living will and health care directive naming someone you trust to make such decisions. Your health care attorney-in-fact need not be a family member.

    I would not be surprised if money played a part of this decision in the minds of the hospital officials.


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