How doctors die, not like the rest of us !

It is a good article. The author, a doctor, explains that many doctors forgo active treatment for themselves in terminal situations. They see the futility and negative outcomes of aggressive treatment on a daily basis and opt out for themselves. Yet patients' miscommunications and the system's defaults drive toward over treatment. One of the most interesting things he asserts is that CPR is counterproductive:
"Many people think of CPR as a reliable lifesaver when, in fact, the results are usually poor. I’ve had hundreds of people brought to me in the emergency room after getting CPR. Exactly one, a healthy man who’d had no heart troubles (for those who want specifics, he had a “tension pneumothorax”), walked out of the hospital. If a patient suffers from severe illness, old age, or a terminal disease, the odds of a good outcome from CPR are infinitesimal, while the odds of suffering are overwhelming."
​
I am not sure of that. I think if I was to collapse today with a heart attack I would want DW to try some chest compressions. There are a lot of people walking around 10 - 20 years after surgery for heart problems. But, I have often thought that the best thing for an 80+ person passed out with a heart attack would be to sit quietly with them for an hour or two before calling it in.

DW and I have been dealing with the tendency to over respond with my FiL who is in late stage Alzheimers. We get calls about weekly from the night nurses that he has fallen and hit his head. On two occasions they were inclined to take him to a hospital even though we have clear instructions to the contrary. If he has a brain bleed, the last thing we want to do is treat it. But it is very hard to hear of accidents and the like and not overreact. He entered hospice on Friday (within the same facility) so it should be much easier for all parties to proceed rationally going forward.
 
If the approach to death and dying in the article appeals to you, I urge you to find out more about an organization called "Compassion and Choices". They lobby for changes to the laws that make this type of death difficult to achieve.

DW and I are in the process of having a revocable living trust and accompanying living wills prepared. We intend to document our intentions with regard to end of life care so that our children and our doctors know what we do and do not want.
 
donheff said:
It is a good article. The author, a doctor, explains that many doctors forgo active treatment for themselves in terminal situations. They see the futility and negative outcomes of aggressive treatment on a daily basis and opt out for themselves. Yet patients' miscommunications and the system's defaults drive toward over treatment. One of the most interesting things he asserts is that CPR is counterproductive:
"Many people think of CPR as a reliable lifesaver when, in fact, the results are usually poor. I’ve had hundreds of people brought to me in the emergency room after getting CPR. Exactly one, a healthy man who’d had no heart troubles (for those who want specifics, he had a “tension pneumothorax”), walked out of the hospital. If a patient suffers from severe illness, old age, or a terminal disease, the odds of a good outcome from CPR are infinitesimal, while the odds of suffering are overwhelming."
​
I am not sure of that. I think if I was to collapse today with a heart attack I would want DW to try some chest compressions. There are a lot of people walking around 10 - 20 years after surgery for heart problems. But, I have often thought that the best thing for an 80+ person passed out with a heart attack would be to sit quietly with them for an hour or two before calling it in.

DW and I have been dealing with the tendency to over respond with my FiL who is in late stage Alzheimers. We get calls about weekly from the night nurses that he has fallen and hit his head. On two occasions they were inclined to take him to a hospital even though we have clear instructions to the contrary. If he has a brain bleed, the last thing we want to do is treat it. But it is very hard to hear of accidents and the like and not overreact. He entered hospice on Friday (within the same facility) so it should be much easier for all parties to proceed rationally going forward.
Click to expand...
Thanks for providing the summary.
 
Sometimes a piece is so well written that to summarize it takes away from it. I think this article fits the bill.
 
grumpy said:
If the approach to death and dying in the article appeals to you, I urge you to find out more about an organization called "Compassion and Choices". They lobby for changes to the laws that make this type of death difficult to achieve.

DW and I are in the process of having a revocable living trust and accompanying living wills prepared. We intend to document our intentions with regard to end of life care so that our children and our doctors know what we do and do not want.
Click to expand...

I want to have all the paperwork in place, but don't have any local friends or relatives.

Maybe I should have DNR tattooed on my chest.
 
Free To Canoe said:
Sometimes a piece is so well written that to summarize it takes away from it. I think this article fits the bill.
Click to expand...
Providing summaries is a courtesy to other members so they know the nature of a link before opening it. If a summary does not do justice to a well written article, a short description of the link will suffice. Community rules say
Please do not post “naked” links, defined as links posted without explanation, interpretation or context.
Click to expand...
This line, posted by donheff, was very helpful.

The author, a doctor, explains that many doctors forgo active treatment for themselves in terminal situations.
Click to expand...
 
Free To Canoe said:
Sometimes a piece is so well written that to summarize it takes away from it. I think this article fits the bill.
Click to expand...


Kind of my way of thinking as well. The title does give the potential readers an idea of the subject content.
 
Khan said:
Maybe I should have DNR tattooed on my chest.
Click to expand...


That's fine I guess, but I hope you'll also spring for the heart option.
That way if I see you flopping around on the floor of the mall, I can have a chuckle before I stroll off to the food court..;););)


img_1137043_0_cb9d3abc9d32a352af8d64dd3392919a.jpg



PS: I recently renewed my CPR, so I guess you could say I've got a bit of an itchy trigger finger..
 
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Khan said:
I want to have all the paperwork in place, but don't have any local friends or relatives.

Maybe I should have DNR tattooed on my chest.
Click to expand...

When my mother moved to an assisted living facility, they gave her a "Vial of Life."

It's a glass test tube about the size to hold a cigar, with screw top, attached to a magnet for putting on the refrigerator.

In the vial, you're supposed to put information about your medications (type, location, etc.), but many people also put in a copy of their advance medical directive (DNR, etc.).

Local EMTs and other first responders are trained to look for this when they are called in. I imagine any kind of highly noticeable placement of such instructions would work as well.
 
frayne said:
Kind of my way of thinking as well. The title does give the potential readers an idea of the subject content.
Click to expand...

Sorry, but your simple "interesting read" comment and then the title "How Doctors Die" doesn't really tell me much about the subject content. The article could have been about how doctors have access to elite care, or go to international centers, or ignore treatment altogether, or smoke more than others, or commit suicide (not that any of the preceding are true).

I agree that DonHeff's summary was quite helpful.
 
Bestwifeever said:
Sorry, but your simple "interesting read" comment and then the title "How Doctors Die" doesn't really tell me much about the subject content. The article could have been about how doctors have access to elite care, or go to international centers, or ignore treatment altogether, or smoke more than others, or commit suicide (not that any of the preceding are true).
Click to expand...

...or the most common terminal diseases affecting those with a Phd. :)
 
That's an excellent article; thanks for posting.

Most doctors would not want for themselves what some doctors do for their patients (often at the insistence of family members). We cringe when we hear "the relative from away is here". That's why it's very important to make your wishes known while you are compus mentis.

As it happens, the incidence of suicide in doctors is quite high, 1.4-2.3 times that in the general population. See below:

Medscape: Medscape Access
 
Khan said:
I want to have all the paperwork in place, but don't have any local friends or relatives.

Maybe I should have DNR tattooed on my chest.
Click to expand...

REWahoo said:
Better spell it out if you do so they won't think the acronym stands for Department of Natural Resources...
Click to expand...

...and also have it tattooed on your back in case you collapse face first.
 
Believe me, they'll turn you over. :LOL:
 
Someone screwed up the subtitle:

How Doctors Die

It’s Not Like the Rest of Us, But It Should Be


It says the opposite of what the article is saying (the subtitle says doctors should die like us, but the article says that we should die like doctors).
 
For ten months of this year, it seemed like every time I stepped foot out of my house, I was going to a cancer medical center, a nursing home or hospitals. I've seen so much suffering...

Fortunately, the doctors DH and I dealt with were compassionate and straight forward.

End of life situations are not easy tasks...
 
Thanks for fixing the OP, Don.
donheff said:
DW and I have been dealing with the tendency to over respond with my FiL who is in late stage Alzheimers. We get calls about weekly from the night nurses that he has fallen and hit his head. On two occasions they were inclined to take him to a hospital even though we have clear instructions to the contrary. If he has a brain bleed, the last thing we want to do is treat it. But it is very hard to hear of accidents and the like and not overreact. He entered hospice on Friday (within the same facility) so it should be much easier for all parties to proceed rationally going forward.
Click to expand...
They're calling because they're required to notify you, right? Otherwise they're following his treatment plan and his DNR, or at least putting themselves in a position to be reminded to follow them? Hopefully they're calling more for "full disclosure" and not to start a coercive argument. I worry about this when I get those types of calls.

Was the hospice decision coming from the falls or from the progress of Alzheimer's?

frayne said:
Kind of my way of thinking as well. The title does give the potential readers an idea of the subject content.
Click to expand...
It's posters with that way of thinking who are responsible for the rule. Otherwise we wouldn't need the rule...
 
My XDW, an RN, pretty much expressed the same sentiments - that way too much invasive care goes on when realistically, all hope is lost. The trick is to have enough knowledge to know when you have reached that tipping point. It would take a very candid doctor to share that information.

I've been involved in two CPR attempts and both failed. At my last Red Cross class, I asked the instructor to share the statistics with the class, so that they knew in advance that it probably won't work. It is a heavy burden to wonder if you somehow screwed up the CPR and let someone die.
 
Nords said:
They're calling because they're required to notify you, right? Otherwise they're following his treatment plan and his DNR, or at least putting themselves in a position to be reminded to follow them? Hopefully they're calling more for "full disclosure" and not to start a coercive argument. I worry about this when I get those types of calls.
Click to expand...
The staff are quite good and are calling out of obligation. Lots of relatives would be bent out of shape if they were not notified of every hiccup. Unfortunately, when they call they will suggest a hospital if, as an example, he has a bad nose bleed from a fall that doesn't stop bleeding quickly. That one was hard to judge -- after a while it cleared up. We also had a hospital recommendation when he was somewhat unresponsive after a fall. That one seemed easier to react to -- we would not want a CAT scan to look for brain bleeds or other damage. We don't want FIL to experience pain or discomfort but we don't want to do anything to intentionally prolong the decline. You get caught up in a lot of doubt, uncertainty and guilt over this. You never know whether you are doing the right thing or the wrong thing.

Was the hospice decision coming from the falls or from the progress of Alzheimer's?
Click to expand...
The progression. They evaluated him for hospice a few months ago and decided to wait. This time they think he is ready. As you know from your research, this could be a long process and he could improve and come back out of hospice. Alzheimers isn't a fast disease.
 
bbbamI said:
For ten months of this year, it seemed like every time I stepped foot out of my house, I was going to a cancer medical center, a nursing home or hospitals. I've seen so much suffering...
Click to expand...
My belated condolences...

I went through the same thing several years ago, seeing my father in a steady decine in his renal failure. He was in and out of so many hospitals and convalescent homes that my memories of various events are now all mixed up of what was happening where.

It affected me greatly, as I was at a severe personal crisis of my own. As both start-ups I was intimately involved with were floundering, I was contemplating a couple of full-time job offers from megacorps that I was doing consulting work for. Do I go back into shackles in exchange for some job security, or do I hang tough doing iffy part-time jobs, while the market was tanking after the dotcom bust?

Watching my father's last years made me decide to stay free of megacorps. Life is just too short, particularly for a guy approaching middle age. I do not subscribe to the current notion that 70 is the new 50, the new middle age. Hell, who's to say I will live into my 70s?

And more than that, I started to spend more money, compared to previous years when I worked hard while telling myself that I would enjoy the fruit of my labor later in my golden years. No, no, baby... If not now, then when?

To borrow the lyrics from Santana,

"You've got to change your frugal way, baby...
Before your life is over, baby..."​
 
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