Tuesday, February 28, 2012

What Do Doctors Do When It Is The End For Them?

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.


Unlike previous eras, when doctors simply did what they thought was best, our system is now based on what patients choose. Physicians really try to honor their patients' wishes, but when patients ask "What would you do?," we often avoid answering. We don't want to impose our views on the vulnerable.

The result is that more people receive futile "lifesaving" care, and fewer people die at home than did, say, 60 years ago. ...
This story from the Wall Street Journal was an eye opener.

It made me grateful that my father didn't try to fight his way back with therapy, an option that seemed unrealistic when it was proffered. It also made us realize that the surgeon who early on advised Tom and his brothers about what he'd do "if it were my mother" was being honest in a way that is rarely seen. (Now, months later, we realize he probably was right. Tom says that in letting themselves be guided against that advice without getting an outside second opinion they should have given his words more weight. However, what's done is done.)

Read the whole thing. This is going to guide me in the future. When I ask "what would you do?" I'm going to insist on a real answer.

(I meant to look for the original article ... here it is at Zocalo Public Square.)


  1. Yeah, but you got to trust that real answer. The system is reaching a point where the over riding priority is to save costs.

  2. In the last ten years, I've become very cynical and distrustful of the medical establishment. I've done too much research, I've grown greatly in my faith, and I've lived through the cancer deaths of both my parents. Net-net bottom line is this: suffering is not the greatest evil; living the longest life medically possible is not the greatest good; medicine is big business; and I, more than anyone else, am responsible for my health and the health of my young children.

  3. Agreed for both comments.

    I think the real question though comes up in the scenario that Tom and his brothers faced. When one doctor says he would not amputate his mother's leg because there would be no "quality of life" left and the other doctor is arguing that rehab works __% of the time and otherwise she will die screaming in pain. Hmmmm, which one do you pick? Not the one that ends with "screaming in pain." And, yet, we now look at the scenario after the amputation where there is much regret because she is merely existing ... and wonder if there had been another opinion about that "screaming in pain" image, would we have received the same forecast about it? Etc.