Sunday, April 28, 2019

End of Life and the Medical Profession

Physicians and nurses deal with the deepest issues of the human condition – life and death.  Our profession brings new life into the world and does our best to bring comfort and peace at the journey’s end.  It is a profound and emotional experience for medical professionals to be with a patient and family when life ends.

There are other professions who routinely confront loss of life.  Law enforcement personnel, paramedics, firefighters and soldiers all are exposed to events that most of us would never wish to experience.

The medical profession and society is struggling to preserve our humanity in a 'cut & paste' world where one's worth is determined by the quantity of twitter followers.  

Hugging a child.  There's no 'app' for this.

On my very first day of medical internship in Pittsburgh, I was called by a nurse to pronounce a patient dead.   I had never seen the patient before.  The only deceased individual that I had any close contact with was the cadaver we studied in medical school.  I entered the room and did not know what I was supposed to do, never have been given any training or guidance on this responsibility.  I learned an important lesson then.  New interns know nothing.  Experienced nurses know a lot.  Ask for their help.  An arrogant intern will be permitted to sink.  The humble intern will be rescued.

This was an elderly patient from a nursing home and this outcome was anticipated.  The nurse patiently guided me through the requisite steps.  I performed this function multiple times throughout my internship and residency, but the only actual memory of these events is with that first patient on my very first day.  It imprinted upon me, much as the first day that I was introduced to the cadaver as a first year medical student in anatomy class. 

Being present with patients and families at profound moments is a privilege and a responsibility.  As we are all suffocating from dehumanizing technology in every sphere of our lives, there are experiences still that cry out for our humanity.   If you or someone you loved was facing difficult medical choices, who would you want in the room with you?  A physician, who might deliver wisdom and compassion or Alexa?

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