Lana Barnes entered Hennepin County Probate Court Wednesday morning determined to win aggressive care for her frail husband and remain his medical decision-maker.
Instead, Barnes possibly could face lawsuits and criminal charges after making a startling admission on the witness stand: She altered a legal document governing her ailing husband's care.
Lana Barnes testified that as guardian for her husband, Al, she felt justified in eliminating two pages of his 1993 health care directive, including passages in which he said he didn't want to be kept alive by machines.
When she admitted her 85-year-old husband to Methodist Hospital in December she provided only a page identifying her as guardian.
In several hearings over the past 10 days, Methodist has sought to remove her from that role, contending that Al is too sick to recover and that her insistence on aggressive care is incorrect and reckless.
Her admission brought a sudden halt to the proceedings, as Referee Dean Maus, Lana Barnes and the attorneys went into a closed-door meeting.
Maus later advised her to hire a lawyer. "This is a very serious matter," Maus said. "You should be careful about what you should say."
The missing two pages of Al Barnes' directive contradicted his wife's insistence that he wanted life-sustaining care. Instead, it indicated that Barnes didn't want to be sustained by respirators or feeding tubes -- devices to which he is currently connected.
"If ... there is no reasonable expectation of my recovery from extensive physical and mental disability, I direct that I be allowed to die and not be kept alive by medications, artificial means or 'heroic measures,' " the directive stated.
Lana Barnes later said her husband had changed his views.
"Al did tell me he wants to live," she said. "He said, 'If there's any chance at all, I want it.' "
No legal action was immediately taken against Lana Barnes or on the petition to replace her as guardian. Maus said he would review evidence and select an emergency guardian soon. A March 3 hearing will name a permanent guardian.
A second document
In a hearing marked by tears and tension, testimony produced a second startling disclosure: That Al Barnes had signed a second health care declaration, in 1994, which named his eldest son, James, as guardian. A Methodist Hospital spokesman said the newer document wasn't discovered until two days ago, when the Barnes family attorney, David Hebert of Forest Lake, produced it. The 1993 declaration was also in Hebert's file, but it had been ripped in half -- indicating that it was no longer valid, Hebert testified.
Barnes' doctors at Methodist believe he suffers from irreparable dementia as well as kidney and respiratory failure and needs to remain comfortable in the time he has left. Lana Barnes believes he has Lyme disease and that long-term antibiotic therapy would reverse his dementia and make other aggressive treatments worthwhile.
Her insistence, and confrontations with Methodist nurses, led the hospital and Dr. Abel Tello, a kidney specialist, to seek to remove her as guardian. Until the case is resolved, a private Minneapolis firm is in charge of Al Barnes' care.
Earlier Wednesday, Deborah Leach, a Methodist nurse manager, said she requested tighter security due to Lana Barnes' conflicts with nurses. She described the wife as "desperate" to evoke signs of consciousness from her husband.
In his testimony, Tello withdrew an earlier statement that Barnes was in a vegetative state. The doctor still submitted that Barnes' dementia is irreversible and that aggressive treatment would be unethical and painful for his patient.
Lana Barnes, acting as her own attorney, tried to establish that her husband was suffering from Lyme, a tick-borne disease, and that mistreatment and misdiagnosis by doctors had led to his decline. Lacking legal expertise in questioning witnesses and submitting evidence, she was rebutted.
While Maus gave her latitude to ask unorthodox questions, he often stopped her from making sweeping statements and arguing with attorneys.
"Ma'am," Maus said at one point, "if you are going to continue to be argumentative, I have no other choice but to cut off your cross-examination."
Stepsons
Lana Barnes cross-examined two sons from Al Barnes' previous marriage, James and Clint Barnes. Both said they disagree with her views and that she denied them a say in their father's care.
James Barnes said they have been distant ever since his father married Lana 27 years ago. The son had refused to stand with his father at the wedding, because it occurred weeks after his mother died of cancer.
Clint Barnes, a California nurse, recalled talking about end-of-life wishes with his father, a sand and heavy equipment salesman and Navy veteran of World War II. "We used to joke he should have 'Do Not Resuscitate' tattooed on his chest," Clint Barnes said, noting his father already had tattoos. "It was kind of a sick joke, but it was the truth."
He described his stepmother as "misguided. It's difficult for her, perhaps, to let go."
Ambulances have been called to the Barnes' farm 78 times since 2002. Almost every hospital in the Twin Cities has treated Barnes. His wife said that bad judgments by prior doctors "poisoned" the medical record and prevented him from getting treatment at other hospitals. That is why she had the ambulance last month bypass other hospitals and drive 46 miles to Methodist.
"He's been worse off than he is now," she said through tears. "He's waiting for treatment."