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Why Doctors Die Differently
Wall Street Journal ^ | 2/25/12 | KEN MURRAY

Posted on 02/27/2012 8:01:31 AM PST by rhema

Years ago, Charlie, a highly respected orthopedist and a mentor of mine, found a lump in his stomach. It was diagnosed as pancreatic cancer by one of the best surgeons in the country, who had developed a procedure that could triple a patient's five-year-survival odds—from 5% to 15%—albeit with a poor quality of life.

Charlie, 68 years old, was uninterested. He went home the next day, closed his practice and never set foot in a hospital again. He focused on spending time with his family. Several months later, he died at home. He got no chemotherapy, radiation or surgical treatment. Medicare didn't spend much on him.

It's not something that we like to talk about, but doctors die, too. What's unusual about them is not how much treatment they get compared with most Americans, but how little. They know exactly what is going to happen, they know the choices, and they generally have access to any sort of medical care that they could want. But they tend to go serenely and gently.

Doctors don't want to die any more than anyone else does. But they usually have talked about the limits of modern medicine with their families. They want to make sure that, when the time comes, no heroic measures are taken. During their last moments, they know, for instance, that they don't want someone breaking their ribs by performing cardiopulmonary resuscitation (which is what happens when CPR is done right).

In a 2003 article, Joseph J. Gallo and others looked at what physicians want when it comes to end-of-life decisions. In a survey of 765 doctors, they found that 64% had created an advanced directive—specifying what steps should and should not be taken to save their lives should they become incapacitated. That compares to only about 20% for the

(Excerpt) Read more at online.wsj.com ...


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To: rhema

“During their last moments, they know, for instance, that they don’t want someone breaking their ribs by performing cardiopulmonary resuscitation (which is what happens when CPR is done right).”

This sounds like BS. Who in their right mind, liability wise, would perform this on anyone if this were true?


41 posted on 02/27/2012 9:54:00 AM PST by headstamp 2 (Liberalism: Carrying adolescent values and behavior into adult life.)
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To: rhema
The result is that more people receive futile "lifesaving" care, and fewer people die at home than did, say, 60 years ago

Definitely have mixed feelings about this statement.

I think it is mostly true that we used to be much more accepting of death as a part of life than we are now.

On the other hand, one can't help but notice the inherent propaganda value of such a statement. It will be yet another method to deny people the care they need or desire once Obamacare fully kicks in.

A Russian friend of mine recalls the way the Soviet government would use such tactics. Whenever there was a food shortage, they would line the shelves of the markets with books about the virtues and health benefits of fasting.

If presented the opportunity, I intend to die gracefully. I don't see the value in merely kicking the can down the road with futile treatment. I accept death as a part of life, and don't see the value of surviving at any cost. I don't want to to live a poor quality of life merely for the sake of being alive.

However, I am certain that the Obamacare bureaucrats will use this rationale to deny care to those who do want it. And that is frightening.

42 posted on 02/27/2012 9:54:50 AM PST by Retired Greyhound (.)
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To: T-Bird45

...”Doctors know their industry intimately”.....

With all due respect, Bird, doctors don’t work in an “industry”. Instead, medicine is a calling to most. I know this intimately as I am the grandson, nephew, son, and spouse of physicians. I work in the medical field, and know many, many physicians. While there are some bad apples, as in every field of endeavor, the vast majority of physicians I’ve known are caring, dedicated, highly trained people who essentially give their lives to their art and their patients. It is very stressful for much of the time and I daresay a detriment to longevity. Perhaps that’s why doctors choose to die differently, if this article is accurate. I don’t know and wouldn’t hazard a guess to that end.


43 posted on 02/27/2012 10:00:13 AM PST by astounded (Barack Obama as POTUS is a clear and present danger to the USA)
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To: Yehuda
I talked with my doctor about my no code desire. He is a lot younger than me, but gave me a hug (he's a hugger) and he said he also was a no code person..

My being a nurse and seeing what I have seen, when I go I want to go naturally. No machines, tubes etc.

My mother held on to life being in a wheel chair, cancer spread to spinal cord, multiple myloma and she fought for every breath...my dad came to my house to die, acute leukemia, no chemo and was gone in 4 days...My mother took 6 miserable weeks even having fought for 4 years in miserable condition, had indwelling catheter, bed sores from the hospital, went from 150 pounds to 70 pounds, her surgical incision from operation on spine for relieve pain as the cancer was breaking through the incision,. Due to her blood work that they came to my house for lab work, she could not receive any chemo due to blood work. I kept her going as long as she wanted until she went into a coma and passed 2 days later.... Her neuro surgeon gave me his home phone # and told me if she lived long enough the cancer on her spine would be growing outside of her body...the incision was split over 1/2 the length of the total incision, but she passed before the cancer broke open outside of her body.....Nope, I don't want to go that way. Most doctors don't either and very few nurses want to be coded.

44 posted on 02/27/2012 10:13:50 AM PST by goat granny
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To: trailhkr1

Mortality rates and causes among U.S. physicians

http://www.ajpmonline.org/article/S0749-3797(00)00201-4/abstract


45 posted on 02/27/2012 10:16:45 AM PST by Garvin (When it comes to my freedom, there will be no debate. There will be a fight)
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To: steve8714
If peritoneal dialysis is an option, if the time comes, I'd consider that. But being tied to a dialysis machine is not a life, IMHO.

Condolences for you and your girlfriend. It's great to have had someone like that in your life.

46 posted on 02/27/2012 10:17:08 AM PST by pgkdan (Rick Santorum 2012. Conservative's last, best chance!)
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To: iceskater

Its a huge difference from your choice to someone else making the choice for you. We have a right to choose what we want. Obamacare will eventually be held unconstitutional. It took 10 years to overturn Mccain/Finegold but it eventually happened....


47 posted on 02/27/2012 10:18:23 AM PST by goat granny
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To: Jack Hydrazine

Thats a crock,


48 posted on 02/27/2012 10:20:28 AM PST by goat granny
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To: headstamp 2
Who in their right mind, liability wise, would perform this on anyone if this were true?

Perhaps I don't understand your point. Typically, you only perform CPR on someone who is presumed DEAD.

Seems to me there is not much to lose...

49 posted on 02/27/2012 10:21:44 AM PST by jonno (Having an opinion is not the same as having the answer...)
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To: old3030
Doctors have a responsibility to tell patients all the options....and the risks.

I wouldn't say "most"....but that's just me.

50 posted on 02/27/2012 10:22:22 AM PST by Osage Orange (E tan e epi tas)
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To: T-Bird45

Your right, ribs break if you compress in the wrong area of the body. In the hospital, we never had broken ribs because of CPR Too many people don’t know what they are talking about, they just think they know....


51 posted on 02/27/2012 10:23:11 AM PST by goat granny
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To: WestwardHo

You are so right.


52 posted on 02/27/2012 10:31:48 AM PST by iceskater (I am a Carnivore Conservative - No peas for me. (h/t N.Theknow))
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To: oprahstheantichrist

“Aging Atheist Syndrome”

Actually, I believe she does. Although, asked if she is a Christian—she answers that she used to go to church.


53 posted on 02/27/2012 10:32:17 AM PST by freeangel ( (free speech is only good until someone else doesn't like it)
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To: headstamp 2
If you are trained, the Good Samaritan laws should cover the potential liability.
54 posted on 02/27/2012 10:36:38 AM PST by iceskater (I am a Carnivore Conservative - No peas for me. (h/t N.Theknow))
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To: headstamp 2
Well....having done CPR on hundreds of patients I can tell you...yes we break sternums from ribs on occasion. ( Especially on the elderly..)

FWIW-

55 posted on 02/27/2012 10:38:31 AM PST by Osage Orange (E tan e epi tas)
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To: HamiltonJay
Actually....I've done CPR on neonates and peds, and young adults...and never cracked a rib.

And I was doing it right.

FWIW-

56 posted on 02/27/2012 10:51:16 AM PST by Osage Orange (E tan e epi tas)
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To: HamiltonJay
CPR isn't just compressions and ventilation.

It involves cardiac med's and electrical shocks too....Even in the field, if EMS is close.

The odds are much better than you are typing.

That said....the odds are generally not good to survive getting out of the hospital...even if you survive the initial CPR.

Unless your cardiac arrest was from near drowning, electrical shock, drug O.D...etc....

FWIW

57 posted on 02/27/2012 10:58:15 AM PST by Osage Orange (E tan e epi tas)
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To: freeangel
I’ve been saying this for years. MIL is 93 and has 7% kidney function and probable leukemia. But she doesn’t want to die—I can feel dialysis and chemo knocking on my door. What a loon!

Your obvious and early solution is simple: a pillow and a pistol. The sooner the better, before she burns through what's left of her savings. God, don't you just hate these "useless eaters" hanging around and making themselves obnoxious and expensive?

</s>

58 posted on 02/27/2012 11:07:01 AM PST by lentulusgracchus
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To: freeangel

Oh she needs prayer then, saying one now.

I have a lot of that in my family as well. Ask the Lord to send the Holy Spirit to bring her whatever it is that she needs for her inner peace.


59 posted on 02/27/2012 11:16:37 AM PST by oprahstheantichrist (The MSM is a demonic stronghold, PLEASE pray accordingly - 2 Corinthians 10:3-5)
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To: Cicero
The important thing is whether you can trust the nurses and doctors in charge. I was fortunate to have put her in a really good Catholic nursing home. And the hospital doctors were constantly trying to persuade me to hurry her death, but at least they never did anything on their own when I refused.

They will become more insistent, more challenging, if the Obama "worm meme" of "death to the useless eaters!" is successful in eating through the moral substance, what's left of it, of the American Republic and its civilized Western view of life.

It really is a culture of death.

60 posted on 02/27/2012 11:18:53 AM PST by lentulusgracchus
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