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How Doctors Die (Read 1499 times)

    Well at least someone here is making relevance to the subject.

      A lot to ponder actually.  Other than telling my kids that a Folger's can is fine for my ashes (if they want to keep some), I haven't done much in the way of planning.  It's on my to-do list, but not entirely pleasant to think about and very very easy to put off.

       

      Thanks for posting.

      E.J.
      Greater Lowell Road Runners
      Cry havoc and let slip the dawgs of war!

      May the road rise to meet you, may the wind be always at your back, may the sun shine warm upon your SPF30, may the rains fall soft upon your sweat-wicking hat, and until you hit the finish line may The Flying Spaghetti Monster hold you in the hollow of His Noodly Appendage.


      A Saucy Wench

        Some doctors die by putting on a stupid marathon and conning his "friends" in to running the damn thing.  Eventually someone snaps.

        I have become Death, the destroyer of electronic gadgets

         

        "When I got too tired to run anymore I just pretended I wasnt tired and kept running anyway" - dd, age 7

          Sounds like she's on the edge.

          Well at least someone here is making relevance to the subject.


          A Dance with Monkeys

            The article is wondrous.

             

            So too is Ennay's post.

              Very interesting article, thanks for posting.  If there is one upside to my mother being a nurse, it is that none of my grandparents suffered near the end with prolonged unnecessary treatment.  She was a nurse for years on complex continuing care and saw thousands of cases of families not wanting to let someone go while the patient suffered.   

              'No matter how slow you go, you're still lapping everyone on the couch'

               

              "Running is a big question mark that's there each and every day. It asks you, 'Are you going to be a wimp or are you going to be strong today?'"  - Peter Maher

               

              "Running long and hard is an ideal antidepressant, since it's hard to run and feel sorry for yourself at the same time. Also, there are those hours of clearheadedness that follow a long run."  -Monte Davis

                Sounds like she's on the edge.

                 

                She IS Death

                 

                The pain that hurts the worse is the imagined pain. One of the most difficult arts of racing is learning to ignore the imagined pain and just live with the present pain (which is always bearable.) - Jeff

                 

                2014 Goals:

                 

                Stay healthy

                Enjoy life

                 


                I fly.

                  Some doctors die by putting on a stupid marathon and conning his "friends" in to running the damn thing.  Eventually someone snaps.

                   

                  Really that's just how one doctor might go.

                  Bring it on.


                  Old, Slow, Happy

                    My father was a family physcian in a small town in northwest Ohio.  He had Parkinson's, a triple bypass, and a bowel resection for colon cancer.  He cold not communcate well due to the Parkinson's.  The doctors at the Universtiy of Toledo Medical Center decided to discontinue treatment because he had internal bleeding, a MERSA infection and was on a vent to assure breathing.  He was getting intravenous blood, antibiotics, and "food".  He had not moved or communicated in any way for three days.  When I talked with him to let him kmow that treatment would be discontinued that morning, he opened his eyes and looked at me.  Remember: this is the first time he moved in three days.  When the doctors talked with us, I insisted that they talk with him to see if they still felt it was time to let him go.  They came back from their talk with the impression that he wanted treatment, including everything they could do for him.  He left the hospital and went home for 1 1/2 years.  Then he moved to a nursing home for two years.  His quality of life was not good.  The Parkinson's made it nearly impossible to communicate with him and he was not able to take care of himself in any way.  It was hard to see him like that, but it was obviously what he wanted.  I felt bad for his tough life, but he got to see his three great-grandsons which he would not have known.  He passed away on September 28 of this year at the age of 84.  He was very obviously the opposite of the doctors in the article.  I'm not sure I agree with his decision since his quality of life was so bad at the end, but he had it the way he wanted it.


                    Fat butt on couch

                      To me the point of the article wasn't that doctors give up on care sooner, but that when someone...doc or not...really understands what their options are and what are the reasonable outcomes they can expect, they elect to stop extreme care sooner.  They don't go through a lot of procedures and treatments that, in the end, will give them little to no benefit and may have a big impact on the quality of their remaining life.

                       

                      The exact numbers escape me, but something like a third of cancer patients have chemotherapy within the last two weeks of their live.  Chemo has significant side effects, and it's hard to justify any benefit in the shape they are in that close to the end.  But I don't think they or their family really understand what is going on at that point.

                      "If you want to be a bad a$s, then do what a bad a$s does.  There's your pep talk for today.  Go Run." -- Slo_Hand

                       

                        I found this very interesting.  

                        - Anya

                          If doctors are the first to give up when presented with a challenge, then that doesn't speak well for their practice. Dead


                          Fat butt on couch

                            If doctors are the first to give up when presented with a challenge, then that doesn't speak well for their practice. Dead

                             

                            That's not what this article said. 

                             

                            Often time patients will continue to be treated past the point where there is any hope...going through treatments which destroy what quality of life they may have in their final days while delivering little to no benefit.  While it should be up to the individual patient to decide at what point treatment is no longer worth doing (IMHO), there are many common scenarios by which this doesn't really happen.

                            a) The doctor and healthcare providers don't want to ruin hope so they continue to offer the chance that things could improve, when realistically that is near impossible.

                            b) For any number of reasons, the patient/family is either not provided with all the information to understand the situation, or time is not taken to make sure they fully understand the situation.

                            c) Patient/family lack the education to be able to understand the situation

                            d) Patient is not in a condition to make decisions and family members are unwilling to give up hope, no matter what it may put their loved one through.

                            e,f,g,h etc etc etc

                             

                            In other words, doctors have both the experience and knowledge to more fully understand their medical situation, options, and likely outcome than most patients.  They have also likely seen enough of the dying process to have a different personal comfort with it than many people.  This does not mean they are the "first to give up".

                             

                            I knew someone a couple years ago who was diagnosed with a cancer of unknown origin that was causing intense pain right from the get-go.  It was inoperable, and given that it was a cancer of unknown origin any chemotherapy given would have been non-specific and highly unlikely to give any real benefit.  It would have certainly, however, caused significant side effects and further decrease in quality of life beyond the misery of the constant pain.  This individual -- a lifelong nurse -- understood the situation fully.  She chose to go home with a pain pump and live out the last 3 months of her life with her grandchildren at her feet, rather than in and out of chemotherapy sessions and potentially the hospital for complications.  Does that mean she was the first to give up?  Hardly.  She just didn't want to flog herself with no hope of it leading anywhere.

                             

                            Conversely, I consulted someone a number of years ago who was diagnosed with early stage breast cancer.  She was so afraid of chemo that she decided not to have surgery and chemo and wanted to go home and let nature take its course.  However once I fully explained to her what she could expect from modern chemotherapy, and that if she went through it she had an 85% chance of a cure, she ended up going for it after all.  Years later now she is cancer-free and says that the chemo wasn't half as bad as what she'd thought it would be initially.  She had been the "first to give up", but with better information was able to make a more rational decision. 

                             

                            It's the rational decision part that this article is getting at...though it could have been a bit better written.

                             

                            MTA:  It is worth noting that in many countries, the gov't-run healthcare systems do not allow for the round upon round of chemotherapy for cancer that we get in the US...the last several rounds of which are often completely futile.  They have a more nihilistic or value-based view of medical care, depending how you want to look at it.

                            "If you want to be a bad a$s, then do what a bad a$s does.  There's your pep talk for today.  Go Run." -- Slo_Hand

                             

                              DW works in health care, and sees time and again patients suffering needlessly for months because their loved ones can't let go.

                              Well at least someone here is making relevance to the subject.

                                Often time patients will continue to be treated past the point where there is any hope...going through treatments which destroy what quality of life they may have in their final days while delivering little to no benefit.  While it should be up to the individual patient to decide at what point treatment is no longer worth doing (IMHO), there are many common scenarios by which this doesn't really happen.

                                a) The doctor and healthcare providers don't want to ruin hope so they continue to offer the chance that things could improve, when realistically that is near impossible.

                                b) For any number of reasons, the patient/family is either not provided with all the information to understand the situation, or time is not taken to make sure they fully understand the situation.

                                c) Patient/family lack the education to be able to understand the situation

                                d) Patient is not in a condition to make decisions and family members are unwilling to give up hope, no matter what it may put their loved one through.

                                e,f,g,h etc etc etc

                                 ....

                                 

                                MTA:  It is worth noting that in many countries, the gov't-run healthcare systems do not allow for the round upon round of chemotherapy for cancer that we get in the US...the last several rounds of which are often completely futile.  They have a more nihilistic or value-based view of medical care, depending how you want to look at it.

                                 

                                Somewhat related (but somewhat off course)....

                                To make a short story long... Smile

                                 

                                In 1993, my oldest son was born at 25 1/2 weeks gestation, weighing under 2 lbs (890 grams).  My wife and I got to the hospital at 7pm, and he was born at 8:30pm.  We were in total shock, and weren't aware of our surroundings, our situation, or our sons condition.

                                We were on vacation out of the country (Hamilton Ontario Canada) to watch a world series baseball game (Go Blue Jays!).

                                He was born at a NICU University research hospital that is highly acclaimed, and within 2 hours of his birth, we were in the process of making decisions regarding test drugs and treatment care. 

                                Quite honestly, we didn't know what the heck we were doing.

                                In 1992 (I believe), a drug came on the market that made the survival rate of these premies better than years past (Surfactant).  Without it, children born at his gestation with his condition were highly likely to die of respiratory distress syndrome.

                                 

                                When he was 10 days old, we partially woke up from our state of shock, and we realized that he might die soon.  At that time, he was recovering from heart surgery (performed 3 days earlier), and an infection caused his vitals to take a radical change for the worse.  At that time, we were given the opportunity to make a decision to "ease" the care and make the final few moments less stressful for our son and for us.  A team of doctors were working on him while we were there at his "incubator" side, and the opportunity to have him baptized was offered during the craziness.

                                We chose (because we were young, naive, in a state of shock, deeply in love with our son, and not ready to say goodbye) to continue with full medical care.

                                He made it through the day and the night....

                                 

                                We spent 7 weeks in that Canadian hospital before being careflighted to a NICU hospital in Michigan.  During our time in Canada, he had 1 on 1 bedside treatment 24 hours a day, he had a team of doctors and nurses (that I can still name today) that worked with him.

                                 

                                Today, he's doing wonderful, possibly because of research drugs, and certainly because of technology.

                                My main experience with the Canadian healthcare system happened during those 7 weeks, and I have nothing but highest praise for their work with my son (as well as the many other kids that have gone through that hospital). 

                                 

                                (Spaniel, I know that you're speaking specifically of the latter years of life, as all of the previous posts have as well).

                                2014 Goals:

                                #1: Do what I can do. <DOING>

                                #2: 365 Hours training

                                 

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