I have tried to make my own little mark in this world. My career as a Medical Educator and Clinician in Gastroenterology (see www.gastroindia.net) and my flirtations with Health Promotion, especially amongst school children (see www.hope.org.in) are shown elsewhere.This blog contains my attempts at creative writing, most being write-ups for Health Adda column of HT City of Hindustan Times (also see www.healthaddaindia.blogspot.com) as well as a few others, and some reflections and thoughts that have struck me from time to time on my life journey.Please leave your footprint on this blog with your comment.


Tuesday, May 31, 2016

How Doctors Die

Unlike the perception of most relatives that doctors treat critical patients callously, they in fact often “over-do” than what may be reasonable.


Says a intensivist “Rescusciation or CPR (cardio-pulmonary resuscitation) looks nothing like what we see on TV. In real life, ribs often break and few survive the ordeal.
"I felt like I was beating up people at the end of their life. I would be doing the CPR with tears coming down sometimes, and saying, 'I'm sorry, I'm sorry, goodbye.' Because I knew that it very likely wa not going to be successful. It just seemed a terrible way to end someone's life."

Doctors fall ill and die just as others in society do. Interestingly in spite of all their knowledge about the body, its ailments and cures, they life expectancy is not much different than the general population.

What is indeed different is what they choose to go through themselves compared to what they do to others. In a revealing article “How Doctors Choose to Die”, Dr Ken Murray points out that doctors more often shun ‘advanced’ and ‘intensive’ therapy.

They more often refuse chemotherapy when diagnosed with advanced cancer, prefering to spend quality time at home. Their decision is perhaps based on their first hand experience of having witnessed the unpleasant adverse effects and futility of these treatments.

Doctors also more often choose to refuse aggressive terminal care treatment. They have seen what is going to happen, and they generally have access to any medical care they could want. They know enough about death to understand what all people fear most: dying in pain and dying alone.

They know modern medicine’s limits. Almost all medical professionals have seen “futile care” performed. The patient will get cut open, perforated with tubes, hooked up to machines, and assaulted with drugs.

In a way doctors can be accused of double standards, applying one set of advice to patients and one to themselves, but the important variable here is the expectation of relatives. If a patient becomes critical, even if he is 85 and is known to be suffering from a terminal disease, the wish of relatives is usually “ Do whatever is possible”.

In the litigant and finger pointing times such as ours, doctors therefore prefer not to leave any stone unturned. Relatives, many of whom may have flown in that day, may derive solace from having gone “all the way” in the care of their dad or mom.

it is this fear of guilt of “not having done enough” that makes relatives agree to submit their loved ones to the dehumanising terminal treatment: surrounded by strangers, hooked to machines, body punctured at several places and not a familiar loving face to see before they close their eyes.

1 comment:

  1. Sir,
    Very well written and thought provoking article. 👍

    ReplyDelete