What don’t doctors want their patients to know?
Thank you for reading this post, don't forget to subscribe!Thank you for reading this post, don't forget to subscribe!I rather be anonymous answering this question because of the potential backlash and fallout. I would like to think I’m a good doctor, I’m sure most of my colleagues who have sacrificed time, energy, family and life to take care of your health and your lives would feel the same. In fact, as an anaesthetist (anesthesiologist for Americans) – my job is literally to keep patients alive as surgeons cut them up.
However, what I don’t ever want you to know, and I may be alone in thinking like this, but from the many conversations I’ve had with my peers and colleagues – I’m probably not – what I don’t ever want you to know is that sometimes you or your parent or child or your loved one would be better off dead.
Death can be a relief, for patients, for their loved ones, for the nursing staff, and yes, even for us doctors.
Case example. I was called to the ward to intubate a 29 year old lady.
She was previously fit, healthy, and loved to hike. She was planning to get married, and she had promised to give up smoking. She had had a niggling cough that had been going on for a two weeks, and after seeing a doctor, she found she had a mass in her lung. Not just any mass – it was a metastatic lung cancer that had spread to her liver, her bones, brain, everywhere. But cancer can be treated, right? There is surgery, immunotherapy, chemotherapy, radiotherapy – surely there’s hope?
She was getting more and more short of breath. She was diagnosed with a pulmonary embolus, and admitted to hospital and started on blood thinners. While in hospital, she had a stroke. Then a heart attack. Her cancer was causing DIC – disseminated intravascular coagulation. But she was still alive. Weakened, but alive. Her family was planning to get a second opinion, to ask for immunotherapy, chemotherapy, radiotherapy – anything. But she was too weak to undergo such treatments.
Two weeks after she first saw the doctor for her cough – her heart stopped while she was having lunch. When I rushed up to the ward to intubate her, CPR had already been in progress for 3 minutes. I looked over her story – metastatic cancer, stroke, heart attack, pulmonary embolus, DIC, multiple metastases.
I asked the doctor in charge – why the heck are we doing CPR? Why am I tubing this patient? Don’t the family know it’s futile?
He looked at me, with despair in his eyes. I knew that look, I’ve seen it many times. I tubed the patient. But it wasn’t for her, it was for the family. They still thought she had a chance. They still had hope. They wanted us to fight for her. So we fought for her, in all futility, we fought. The ICU specialists refused to accept her into the ICU, so the medics ventilated her on the ward, CPR going on for an hour more before they finally called it. The family grabbed at me as I passed them – I shook my head, and offered my condolences. The medical guys could do the family meeting – I had to get back to theatre where emergency cases were piling up.
It was Christmas Eve.
I could only offer my condolences and sympathy. But I could never tell them what I truly thought – whew. It’s finally over.
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