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Why Doctors Die Differently
Wall Street Journal ^ | 2/25/12 | KEN MURRAY

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 ...


TOPICS: Culture/Society; Editorial
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To: freeangel
Sorry you are catching so much heat, from people who don't really care about end of life issues, anyway.

I will never forget the vitriol dished out to those of us who tried to help keep Terri Schiavo alive.
She was not dying from a terminal disease. She merely required palliative care. Food, water, simple nursing for a completely disabled person, with a projected lifespan of over thirty years, before her state ordered execution.
She was forcibly starved and dehydrated, to death.

And yes, her “condition” differed greatly from your family member.

At the end, the huge number of people who claimed they personally wouldn't want to live that way, meant society was somehow justified in actively killing a person who was not in fact, dying.

OTOH, those same people will rail against halting futile medical measures, that merely prolong the death of terminally ill people.

81 posted on 02/27/2012 5:29:46 PM PST by sarasmom ( http://www.youtube.com/watch?feature=player_embedded&v=xZsFe6dM3EY)
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To: sarasmom

It will be interesting to see how Americans react as the Federal government begins targeting useless groups of Americans for death through socialized medicine’s Federal denial of care. It will be announced with claims that their lives are not worth anything and that they cost their families and taxpayers too much.

I bet Americans go for it. This is how the Left in the US will murder it’s Stalin quota. They can target people by politically incorrect generation and by region for death.

As long as they have a good materialistic excuse, Americans will celebrate the executions.


82 posted on 02/27/2012 5:39:46 PM PST by SaraJohnson
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To: headstamp 2

The liability can’t be that high- if someone needs CPR they will definately die without it so it comes down to a choice between broken ribs or death...it has been a while since I was an EMT (1970s-1980s) but at the time we were told the only liability is to do it on someone that doesn’t need it.


83 posted on 02/27/2012 5:58:37 PM PST by Tammy8 (~Secure the border and deport all illegals- do it now! ~ Support our Troops!~)
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To: clee1

Thank You for your honesty.


84 posted on 02/27/2012 6:03:33 PM PST by Randy Larsen (No Romney vote from my family!)
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To: Yehuda

No, it’s what happens when it’s done too hard. Now if you are older or have osteoporosis even the necessary push down could fracture ribs. Normally ribs do not break.


85 posted on 02/27/2012 6:17:25 PM PST by Secret Agent Man (I'd like to tell you, but then I'd have to kill you.)
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To: WestwardHo
I get sick of people dumping on doctors--and other medical personnel.

Will never forget knowing a smug, popular small-town lawyer. Every Christmas his doorstep was overflowing with Omaha steaks, crates of wine and booze, all the expensive fancy gifts from grateful clients. I understand that is common among lawyers who get their clients what they want--and probably don't deserve.

He later lost a fortune on Lehman and Wachovia.

And I also knew a middle-aged ER nurse who got a simple "thank you" letter from a grateful patient. She started to cry, and everyone crowded around as she opened the little card thanking her for saving a life. The card was passed around in awe. Imagine! A thank-you note!

I cried, too, only a few tears of pure fury at the vulgar ingratitude of human beings, who lavish booze on cheesy lawyers but stiff the woman in the ER who saved a life, who was so moved at a scrap of paper that said "thank you"--

So dump on doctors, folks. They're retiring like crazy and you may not be able to find one when you need one.

86 posted on 02/27/2012 6:24:41 PM PST by Mamzelle
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To: Mamzelle
They're retiring like crazy and you may not be able to find one when you need one.

I won't dump on them, but I will say that as it is now, when I need one, I can't afford one.

87 posted on 02/27/2012 6:33:25 PM PST by JoanVarga ("Yes We Can" It's not just a slogan. Apparently, it's a threat.)
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To: An American!

Thank You for this blog!


88 posted on 02/27/2012 6:46:24 PM PST by Randy Larsen (No Romney vote from my family!)
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To: Jack Hydrazine; zeestephen; trailhkr1; goat granny

From another Freeper:

Results: Among both U.S. white and black men, physicians were, on average, older when they died, (73.0 years for white and 68.7 for black) than were lawyers (72.3 and 62.0), all examined professionals (70.9 and 65.3), and all men (70.3 and 63.6). The top ten causes of death for white male physicians were essentially the same as those of the general population, although they were more likely to die from cerebrovascular disease, accidents, and suicide, and less likely to die from chronic obstructive pulmonary disease, pneumonia/influenza, or liver disease than were other professional white men.

http://www.ajpmonline.org/article/S0749-3797%2800%2900201-4/abstract


89 posted on 02/27/2012 7:51:56 PM PST by Slings and Arrows (You can't have Ingsoc without an Emmanuel Goldstein.)
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To: SaraJohnson
Oh yes, a great many of my fellow citizens are going to cheer on the death panels! They've already done so IMHO.

But as to your comment that:
“As long as they have a good materialistic excuse, Americans will celebrate the executions”

No, it isn't due to “materialistic” excuses.

It is due to the fetid, stunted minds of “secular progressives” and their hordes of ignorant usefull idiots amongst various “religious progressives”. It seems they have achieved parity, if not a majority.

Back to anarchy, and the dark ages we all go!

90 posted on 02/28/2012 7:55:31 PM PST by sarasmom ( http://www.youtube.com/watch?feature=player_embedded&v=xZsFe6dM3EY)
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To: Yehuda

I was on the ambulance crew of a medium sized city for a couple of year.

Did CPR lots of times. Only one time that I can recall when the first compression did NOT make that cracking sound.


91 posted on 02/28/2012 8:59:29 PM PST by lightman (Adjutorium nostrum (+) in nomine Domini--nevertheless, Vote Santorum!)
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To: Slings and Arrows

The data used in your comment was gathered between 1984 and 1995.

The life expectancy for all Americans in 2011 was close to 79 years of age.

Women have almost a 5 year advantage on men, and whites have almost a 4 year advantage on Blacks.

High income males have about a 5 year advantage on low income males.

I can’t find the 2011 average life expectancy for white male doctors, but I’m certain it’s over 80.


92 posted on 02/29/2012 1:38:15 AM PST by zeestephen
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To: headstamp 2

Because they are ABSOLUTELY gonna die without it... and probably sill anyway.

You do whatever you can to save a life, because each is precious.... even though usually futile


93 posted on 02/29/2012 3:20:39 AM PST by clee1 (We use 43 muscles to frown, 17 to smile, and 2 to pull a trigger. I'm lazy and I'm tired of smiling.)
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To: clee1
***Coding someone is an ugly, brutal business; and the patient rarely survives***

Don't know where you saw CPR done, but the patient is dead to start with or they wouldn't be coded in 90% of the cases.

In the hospital its an orderly medical procedure...Nurse usually #1 to find patient.calls code,

another nurse brings back board to roll pat. onto.

Nurse starts CPR and within minutes respiratory therapy shows up, to intubate if necessary and takes over CPR,

if patient has no IV lines, nurse puts one in,

doctor arrives and takes over calling out medication to medication nurse that has responded to the code

after a code goes out over the speaker system, its only minutes until everyone that is to respond to all codes is in the room.,

If patient can be borough back and stabilized, they are taken by the bed they are in to ICU or RICU.

I have never heard of broken ribs, but if done by someone not really knowing what they are doing, it can happen.

For some, after a period of time with no responses the patient IE: flat lined and no cardiac response the code is called off and the patient is deemed dead by the attending physician.

artificial breathing by someone from RT is discontinued. If the heart responses and stablilitzed the patient may at that point be put on a mech. ventilator...

Every person in the room has a job and each does it well. any personal not directly involved leaves...

If the person is elderly, I can understand broken ribs due to age and condition of bones that break easily. A healthy young man or woman, broken bones don't usually happen in hospital setting....

I think your % that leave hospital is about right.

Done under the best of conditions, CPR is not a miracle and everyone survives, but they were dead to start with.

To an outside observer it may look chaotic, but it is in fact not.

94 posted on 02/29/2012 4:14:52 AM PST by goat granny
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To: SaraJohnson
I feel sorry for my grandchildren and the american they will mature in..Its not the america I grew up in...The government is in everyone house, lightbulbs, toilets, showers, what you can and cannot do with your property..I have said for years we don't own any property, we rent it from the government in the form of taxes that can go into the thousands for a modest home....Glad I am in my 70's and won't be around to see the worse, and it coming...but each individual has the right to make their own decision of how they will die....I think Obama care will eventually be declared unconstitutional by the S C.

That still doesn't get the government out of our homes, only doing away with departments like the EPA etc. will get them out....

95 posted on 02/29/2012 4:52:40 AM PST by goat granny
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To: Slings and Arrows
Once had a doctor tell me that doctors that drink usually don't get liver problems...its because they know what to eat and keep on a good food regiment...most alcholics quit eating and just drink, or eat crappy. If your going to drink alchol, eat properly....not that I would recommend drinking as a vocation....a fifth of bourbon last me a year. For some its a day....and not a good way to die. I have seen some horrible alcholic deaths..

One patient I remember was in his mid 30's married with 3 children....I went into his room one day and asked if there was anything I could get him. (we keep juices etc on the units) his answer shocked me...he said yea, get me a beer...

96 posted on 02/29/2012 5:33:17 AM PST by goat granny
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To: GrandJediMasterYoda

Wow, I checked and you’re right. 5 year survival rate is 4%. I knew it was bad, but didn’t realize it was quite THAT bad. I’ve known 2 people who died of it and yes, it seems more common than I would have thought.


97 posted on 03/04/2012 2:20:33 PM PST by brytlea (An ounce of chocolate is worth a pound of cure)
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To: markman46

I had CPR performed on me, and if they cracked any ribs I never knew about it. Oh, and I survived. ;)


98 posted on 03/04/2012 2:28:40 PM PST by brytlea (An ounce of chocolate is worth a pound of cure)
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