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 ...
Same with me. They ever told me I had PC, I would do exactly what this doc did. Go home and wait for the end. I don’t think there is anyone on this planet who has ever survived PC, you get diagnosed with that, they can prolong your life but at what cost? I look at someone like Patrick Swayze who I believe prolonged it by a year, yet near the end the guy weighed about 90 pounds and you can imagine the hell he went through. What amazes me is how many people get this thing, it’s as common as table salt it seems.
It’s a tough call. I worked with two men. One was young with a young family. The other man was in his late ‘60s.
They were both diagnosed with colon cancer. The disease followed the same course in both.
Understandably, the young man when all out for chemo, etc.
The older man opted for comfort and no chemo.
They died within weeks of each other.
On the other hand, a friend had a malignant tumor in his heart. Chemo and radiation destroyed the tumor, and he fully recovered, but what a long gruesome trial!!!
My own mother lived with untreated colon cancer for more than 10 years. She lived to 82.
Educating ourselves to make informed decisions is essential.
It’s accurate. A few broken ribs was a small price to pay for an additional three years with my dad.
And which I found out later, at his deathbed, that I had no idea what that meant.
After 15 days on a respirator they told me they had to take him off, or he would be stuck on a respirator until he died; and the doctor said he probably wouldn't survive if they took him off. I had to have a talk with him and give him the news.
Now understand, he'd been unable to communicate verbally the whole time he'd been hospitalized, and we were communicating by me talking, him blinking and squeezing my hand. And at the end, he made the decision, to the extent he had one.
A word of advice - talk this sort of thing out with your kids before the need arises. I guarantee, they need more clear advice than a quip about not being a vegetable.
There is an upside but several downsides for doctors with this.
Doctors get a bum wrap. Damned if they do. Damned if they don’t.
I’m old. As I watch family members die, every Doc has been very compassionate and done his best to follow the families wishes.
If the patient and family want life and treatment no matter what, the doc will do that.
If the patient and family are given all the information and decide for comfort care that’s what the doc will do.
I will never forget the Doc that explained my father-in-law’s extensive cancer. He was able to communicate really bad news so gently!!!
Doctors are people. They have families. They take their patients home with them in their thoughts and prayers. They are deeply touched by human suffering. Not once in awhile, but daily.
From the FWIW Department, my doctor, a woman in her late thirties, just quit and is moving to Costa Rica to practice medicine.
Yes. I am a ER/ICU nurse.
CPR, when done properly, WILL break ribs and < 7% of people that have CPR done survive to leave the hospital.
Those are stone-cold facts. The reality of CPR/coding is NOT anything like you see on TV.
Coding someone is an ugly, brutal business; and the patient rarely survives.
Nicely done. I agree with you.
Oh, ok, my mistake. My response, was to your response at post#5, where the poster asked for more information about CPR resulting in broken ribs. I must have misunderstood your response (or maybe you hit the reply button, not necessarilly replying to the comment at that post). I thought you were saying that it was untrue and sensationalist that someone mentioned that CPR breaks ribs. My mistake, I apologize if that’s not what you meant.
This is absolutely true, if you do CPR correctly, you are going to crack and break ribs, to apply enough pressure to stimulate the heart, you have to. What they also don’t tell you about CPR is that your odds of actually restarting someones heart with it is only about 1-2%. Its a hail mary at best.
Its not a CAN be broken, it is a WILL BE CRACKED, period. If you do CPR correctly you are going to crack ribs, period. There is no IF involved.
To apply enough pressure to actually cause the hear to compress you are going to crack ribs to do it, there is no CAN involved, this is an absolute WILL.
If you don’t crack the ribs, you aren’t putting enough pressure to stimulate the heart, period. Also, your odds of restarting a hear twith CPR even when performed 100% correctly is only about 1-2%.
That’s probably very lucrative for her. I’ve lived there (and have family who do), and there’s a bustling private system that picks up the people who fall through the cracks of the socialized medicine racket. They have a slightly higher life expectancy than we do, and I suspect better overall general heath (70% of them are not overweight). Probably not a bad deal for her. If she could have done it a few years ago, she’d probably have been able leverage her dollars better, but I’m sure either way she’s probably doing quite well.
Can you post a link to this incredulous information.
I liked your answer the best... thanks.
My beloved girlfriend was on at-home Perineal dialysis with a cycler for two years. She had other cards stacked against her and at the end was morphined to death while unconscious, but we travelledand had as good a life as could be.
I wouldn’t trade those years for anything. She was the Best. Girl. Ever. She saw it her duty to fight for her life as long as possible. Too bad the hospital didn’t.
Wow. Does she also have AAS (Aging Atheist Syndrome)?
That said, I work in the health care field..and I totally agree. I've seen enough....
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