How Doctors Die

Zocalo ^ | 11/30/2011 | Ken Murray

[cycjec]

It’s an excellent specimen of its ilk, and a timely
reminder of what those doing the planners have in mind,
so thanks for the OP. However, we here at FR have become
rather sensitized to people who aver “they are only
airing the issues” etc. when they are really advocating
e.g. medical abandonment. It’s not that easy to write
a really short introductory OP about one’s motives for
a post either, so I’m not telling you that you must do
so, but it’s a good idea. *especially* if you truly are
wondering “what does this person mean” as many would
seeing this for the first time, by which I refer to many
who *aren’t* on FR so don’t have the benefit of the
background it provides.

[cycjec]

But all too often a DNR, actual or fictitious, means
“DO NOT TREAT”. Nor do I trust those who advocate
withholding *effective* medicat treatment to competently
deliver palliative care.
I refer you to “rlmorel”’s posts on this thread for discussion
of unnecessary medical interventions, which do occur.

[kalee]

My mother’s doctor’s partner did not want to treat my mother for pneumonia. Our discussion got really nasty, on her part. I just said treat her now and walked away. It’s a long story but she did not die that night. So I can say I have seen the enemy and won one battle and I know I can fight again if I must.

[JerseyanExile]

Alright, I’ll keep that in mind in the future. I haven’t been on FR all that long, so I’m still learning the general forum culture here.

[Coldwater Creek]

Thank you!

[boop]

Thanks for the correction. I did a literature search and came up empty. I must have been thinking of an article in the lay press.

[LadyDoc]

this sounds about right, because we see the side effects of treatment and chose the “hospice” way: To live life comfortably until the Lord takes us..

My husband retired here to the Philippines rather than the US partly so he can live at home but partly because he doesn’t want a lot of stuff done if it’s his time to go....NO cpr, NO dialysis, NO feeding tube...

On the other hand, my brother is on an expensive chemotherapy medicine for four years that has kept him alive and well enough to work. I advised him to start it although experimental at the time because the studies of stopping the cancer growth were good.

[dawn53]

I believe everyone has a quality of life. It is how it is perceived.

I believe that too. My mom was bedbound for the last 18 months of her life, totally unable to take care of herself. We had her at home with round the clock nurses (not everyone can afford that, I know...nursing care round the clock back then ran around $1200 a week, which is cheaper than a nursing home, but nursing homes can be covered by insurance, round the clock nurses aren't

But I'm talking about forcing on someone an intervention that they would not have chosen for themselves, in the case of my FIL. He didn't want a ventilator, he didn't want a feeding tube. He was 93 years old, and unconcious, but had laid out his "desires" as far as medical intervention way before he was terminal. Quality of life is one thing, forced medical intervention just because we have the technology is quite a different matter, IMO.

[GOPJ]

It was a blessing that you and your father had that time together. Thanks for sharing.

[rlmorel]

It does seem strange to me that a positive thing could come out of something so negative, but...it did...

[freekitty]

I agree.

[freekitty]

My grandmother’s illness was back in the 50 and 60’s when people took care of their families.

[TheOldLady]

My take away from the article is that someone my age should just die and not go through all the pain, expense, and fuss of trying to keep on living.

IOW, this is a propaganda piece and a precursor to the "duty to die" lectures that people have to attend every two years after the age of 65.

Go pound sand, "Dr." Murray.

[stig]

Expect to see more and more articles like this as Obamacare kicks in and we are all encouraged to forgo that bothersome end-of-life care to make the numbers look a little better.

Having recently finished medical school I can assure you this attitude is drummed into Doctors. Over and Over again they hear about how much money is spent in the final years of life. In one sense DUH of course in the last 6 months of life. When you are fighting death it's expensive. The thing that's lost is that the experience gained on an 80YO man is excellent training for making sure a 30YO man makes it through if some bug or bacteria or accident should befall him.

Pancreatic cancer is very rare so the analogy isn't very applicable to the things that most people end up in the hospital for. But young people end up in the hospital and they end up in the ICU. Imagine you stop trying to fix all those 80 year olds. Now that 20 to 30 something gets a doctor that deals with 20% of the ICU patients he/she used to. We are going to start losing a lot more young people because Doctors aren't going to have the training and more importantly aren;t going to innovate and push medical technology any further.

Lastly let's take a simple thing like a code. Codes are run all the time in hospitals people get chest compressions and drugs. The simple fact is that more often than not people don't come out of them. Is that a reason not to do them? You do save some people. They are not fun for the person on the receiving end. But if it buys you 2 more years of life then why not. The doctors with the attitude in the article will say oh you're assaulting the person and interrupting the natural process of dying. But the flip side is you could be home and in hours of agony before you die. It's not always peaceful. It's not like you get to pick your death out of a catalog.

I'll get off my soap box but that attitude really gripes me. Why go into medicine at all if you didn't want to try to help people stave off the inevitable. In reality that's all medicine is trying to do is delay death.

[goat granny]

I can assure you that a DNR does not mean do not treat...Having worked as a nurse for 10 years in hospital the patients I have treated get treatment but if the person goes into cardiac arrest extra ordinary treatment is not given usually family is aware and usually has a family member present most of the time. My father signed a *no code* he was given all that was necessary He did leave the hospital AMA after talking with anesthesiologist the night before his scheduled operation. He was required to sign a document stating he was leaving against "against medical advice

Is it possible that for some hospitals they have such a policy but never heard of one. The liability if a hospital didn't give basic care and treatments ordered by the doctor and all things that are not extraordinary would be high. Cha Ching is not something hospitals want to hear in a court. Its the doctor that determines what treatment the patient gets and he does it in writing as part of the patients chart...

If the patient spikes a fever and you think they won't be given aspirin you are way off. If the patient has a bed sore, the doctor orders the treatment and treatment is given....depends entirely on what the doctor puts in writting and they aren't going to hang themselves by being stupid.....(Have know a few doctors that were stupid) but some stupid order is usually not followed, it is reported and verified with a call to the doctor....I had a doctor write an order for a specific medication and I was medicine nurse that day. A call to pharmacy with the med. ordered and pharmacy called the doctor and got the order reversed...

Some times an order is given by mistake. The doctor is usually grateful it was caught by nursing staff or pharmacist...

[cycjec]

I’m truly grateful for your comment. In substandard
facilities, however it can have that effect. I’ve heard
of it being discussed by medical professionals who were
as outraged as you were. I didn’t mean to imply it was
a formal policy.

[goat granny]

I was speaking of hospital's but cannot vouch for what goes on in nursing homes...some are nice some are horrible. any one that has to use a nursing home for someone they love, check them out. Use your sense of smell, does the place smell strongly of urine or feces...Peek into room and see how the patients are treated. Are the floors clean, etc...There are some really nice nursing homes, but you have to look real hard for them...attitude of staff etc....I know that some people need such type of care that they cannot be taken care of at home...its a sad fact of life...

I was able to care for my mother in the last 6 weeks of her life only because I was a nurse...thats not possible for everyone...

[Churchillspirit]

My sympathies to you in the loss of your wife.

May she rest in peace.

God Bless you.....

[Osage Orange]

Well....I'm in the Health Care biz.

Every case is different....

I'm so sorry for your loss.

My older sister died..in 2000..of a brain stem stroke. She was also 49!! It broke my heart!!

She was taken off of the ventilator after 24 hrs. Because there weren't any brain waves....and she wasn't "there". No pain, no feeling.....

I understand your post. I've been there, on both sides of the bed.

Regards,

[EDINVA]

Your post is beautiful. So sorry for your loss of your wife. I can’t imagine the pain, but you have peace knowing you made the right decision for your wife and yourself.