Oftentimes, physicians and patients face bad options. I wish that the choices that patients faced were all good ones, or at least had one option that was likely to yield a favorable result. This scenario is further complicated as medicine is an uncertain discipline with moving goal posts and changing facts. We make decisions and recommendations based on the current state of facts and our medical knowledge and experience. We may counsel a patient against surgery, only to discover days later in retrospect that an operation would have been the right choice. An adverse outcome may result from an excellent decision.
There are many medical circumstances when the options are equally foreboding. A man may be suffering frequent episodes of angina, chest pain caused by hardening of the coronary arteries. He is on maximal medical treatment, but the symptom persists. This is not only limiting his life activities and pleasure, but also significantly increases his risk of a heart attack. His cardiologist has concluded that only a coronary artery bypass operation can help him. However, the heart surgeon is greatly concerned that because of other illnesses and conditions that the patient is suffering from, that his surgical risks are substantially increased. In other words, his condition after surgery might be worse than he is now.
Surgery or Status Quo?
It may be that my hypothetical cardiac patient is suffering from chest pains as a result of the current state of our electoral politics. Perhaps, his heart has been stressed from failure to accept that the two presidential candidates of our major political parties are the best that this nation produced. In a country teaming with talent, we are left with two highly flawed candidates who most of us can’t stand. I surmise that many Americans have developed chest pains and other ailments as a result of demoralizing and dirty politics that each week sink deeper into a slimy abyss.
I cannot count how many of my octagenarian patients - who have never missed a presidential election - are sitting this one out with disgust.
With regard to this election, I also feel that I face two unpalatable options. How to choose between strychnine or cyanide. Which option is better, quicksand or a cliff?
Remember, when we read The Odyssey years ago and read of Odysseus’s ship navigating between Scylla the 6-headed monster and the deadly whirlpool Charybdis? Two terrible options. Many Americans today, in an electoral sense, are on a similar journey.