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 ...
Sorry if I offended through semantics or word choice, it was not my intent. I agree with you about medicine being a calling since the course of study is so long before actually getting into the real application of the knowledge gained. I am the son of an RN and my observation of the care level of most health professionals mirrors yours.
My comment was not about bad apples or poor care, it was about the special knowledge gained from being on the inside that is not necessarily shared with patients or families making the decisions about how to approach a life-threatening disease like the pancreatic cancer described in the original article. I take the view that there are medical professionals that believe not providing full information is a kindness to the patient/family because the doctors don’t want to dash any hope the patient/family have. I don’t believe this is through any ill intent.
I hope I have provided a little more clarity on my first comment.
It’s my understanding that the point of chest compressions is not to start the heart, but to compress the heart to force oxygenated blood to the brain and other organs until such time that the heart can be started (by paddles).
“The sooner the better, before she burns through what’s left of her savings.”
Nope—she’s gone through her savings—but she doesn’t seem to be at peace in the least. What quality of life do you think a 93 yr old has on dialysis and chemo. For the last 20 years she has been unwilling to do anything but watch TV and do crosswords.
Thanks for the prayer. She DOES need the Holy Spirit.
“With all due respect, Bird, doctors don’t work in an “industry””
It is most certainly an industry. It consumes 1/7th (and growing) of all our economic efforts. Doctors are an intimate part of it, and they are often passionate and professional about it.
There is no shame or insult in calling it an industry. Many doctors are well compensated for their efforts and education, as it should be (for some of them).
I don't know, why don't you ask her, instead of putting a pillow over her face?
Your indignation at her inconvenient "bitter clinging" to life is pretty self-evident. Gut-check time.
Of course, you are right.
I just don’t think it hurts to be skeptical and question the motives of people who stand to gain financially based on what they recommend — in any field.
Obviously, the reason you hire a doctor is because he or she is supposed to be an expert, and you want an expert opinion. I am not even saying that “most” doctors are not good people. Money can talk loud.
Works for me.
I’m not pinging doctors as much as pointing out that their job has hazards, one of which is assuming the worse.
Somewhat like police officers have a habit of eating their gun when things go south for them. It used to be that it was common when doctors got a terminal diagnosis to give themselves a lethal shot of morphine and call it a day.
I personally prefer the Ambrose Bierce solution, of just taking an extended holiday in rural Mexico, making friends with the locals so that when you go, there is not a lot of fuss. Not really different from a doctor who just decides to let nature take its course, just a step further.
I know some cardiologists who have do not resuscitate necklaces, though it is rare that they end up in such a situation, instead getting something long, slow and chronic that they see coming from a mile away.
I understand your view, but I think it’s wrong. While the delivery of healthcare services does comprise some 14-15% of our economy, I contend the practice of medicine is not and must not be construed as an industry. That is one reason we’ve got to the point we have with Obamacare. Health care services are not like other industrial services in that they are - ideally - personalized and compassionate.
Medicine, despite what the tinkerers think, is as much art, maybe more, than it is pure science. There is no cookbook, although some would like it that way. It’s just that for most patients, outcomes are unpredictable.
They don’t call it a practice, for nothing.
Good post...............
“Medicine, despite what the tinkerers think, is as much art, maybe more, than it is pure science. There is no cookbook, although some would like it that way. It’s just that for most patients, outcomes are unpredictable.”
A large fraction of medicine is of the lookup table variety, match symptoms to pills, collect the fees direct the patients to your labs, have a nice day.
The Art of Medicine is only the domain of a select talented subset of physicians and surgeons.
We can agree to that much, I think. Nonetheless - they have to have the technology, the manufacturing, the pharmaceuticals the brick-and-mortar facilities behind them.
It is every much an industry as anything else is in this day and age. Deploy capital, serve your market, collect revenues, grow market share etc.
In my town, the average doctor retires at 48.
Education of end of life care is very important!
Here is a nurse viewpoint:
http://www.codeblog.com/archives/public_service_announcement/how_do_you_suppose_being_coded.html
I wish I had been told this so I could have had discussions with older family members before crisis time. Read, Research and make decisions on what is best for your and your loved ones situations.
Give me a call when you’re 93. By then enough laws will have changed so we can legally put a bullet through your head.
I’ll bet she hates you as much as you hate her. Small wonder... You’re disgusting.
Actually, doctors and elected officials, when it is their life at stake tend to go to natural herbal medicine, get cured, and live on for a few more decades.
Some years ago Mrs. OldPossum and I consulted with our attorney regarding end-of-life care and he provided us with an elaborate questionnaire as to what we wanted done in certain instances. I selected no heroic treatments, none at all.
The advance directive has teeth in it, unlike a lot of stuff stuck on wills. My wife has health power-of-attorney and if the hospital ignores her stated wishes on my behalf she can take them to court.
Now, there’s a language they understand.
“I’ll bet she hates you as much as you hate her. “
What planet are you from? We moved her here from Fla. several years ago where she was spending much of her time in hospitals. She has been maintaining some semblence of health since she’s been here and not had one hospital admission since we’ve been taking care of her. She simply refuses to deal with reality. Perhaps I should take your advice and recommend to her to take every extraordinary measure to extend her life. CPR, tubes, etc. Would that make you happy?
One thing to remember in this new age of socialist medicine. Leftists lie in the name of science to advance their agenda. They are doing it with global warming; they will commence doing it with medical care now that they control medical care.
We should stick to what we know from experience of those we trust around us. Don’t blindly follow authority now that it is corrupt. The ideology’s central goal is population reduction - beginning with denial care to elderly and handicapped. They will try to scare and gulit old people into ending their lives.
Stick to what you know.
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