Knowing How Doctors Die Can Change End-Of-Life Discussions

“Nora Zamichow says if she and her husband, Mark Saylor, had known how doctors die, they might have made different treatment decisions for him toward the end of his life.” ~Maya Sugarman/KPCC

Morning to you all!  It has been a while since I’ve posted anything (just as I foretold,) but I couldn’t pass up the opportunity to share this article with you.

Have you ever had one of those moments in life when a photo, an article, a sound or a taste somehow resonates with you on a deeper or spiritual level, so much so that you end up unearthing a well full of gut-wrenching emotions that you thought you no longer had the capacity to feel?  That is basically where I am right now.  I am at the bottom of my well.

As a nursing professional, I find myself dancing a fine line between remaining objective and detached from my patients and caring so deeply for them that I make the classic misstep of getting attached.  The longer the patient’s ICU stay is, the harder it gets.  Soon enough, your “long-term player” ends up being the type of patient that you don’t even require a formal report on at shift change, because you know them like the back of your hand.  However, what happens when there are not any more life-sustaining interventions or measures available to your patient, but they are still incredibly ill?  What happens when your chronic patient, whom you now care for deeply, is wasting away before your eyes, stuck in some sort of mortal purgatory in which they cannot live, nor can they die?

This very phenomenon replays itself on a regular basis in hospitals and medical centers across America.  I myself have dealt with (and continue to deal with) the agony and ethical mire that accompanies caring for patients that are suspended in this “Hospital-Acquired-Limbo,” of sorts.

I feel that discussing medical futility, quality of life and the realistic outcomes of “doing everything” with deteriorating, chronically-ill patients and their families is an incredibly underutilized option in some facilities.  These conversations are difficult for clinical care teams, as some seem to directly associate discussing the transition to palliative care with admitting defeat or failure.  However, it appears to me that we are in fact turning a blind eye to an integral part of our patients lives- the end of it.  We rob many patients of the opportunity to die a dignified death, offering them the “full package,” but never really showing them the more peaceful and less traumatic alternatives available to them.

Earlier today, I found myself delving into an engaging discussion with a colleague regarding this matter, so it seems almost bizarre to me that I would scroll past the article that I am about to share with you, while trying to drift off to sleep in these wee hours of the morning.  I implore you to read the article in its entirety and start to do some soul-searching on what would be most important to you at the end of your life, or that of your loved one(s.)  Ten out of ten people pass away at some point, so don’t delay conveying your wishes to those that you love, regardless of what your wishes may be.

I must apologize for being such a “Debbie-Downer” this morning, but sometimes, as those of you who are healthcare professionals already know, some patients really have a way of tugging on your heart strings and leaving a mark on your heart.  Days, months and years pass you by, but you don’t forget their names, nor their faces- not a blessed thing!  It can keep you up at night, wondering how things could have been executed differently during their stay, visualizing the graphic images of their last moments on earth, processing the bitterness and hate you feel towards the world when watching a good person die a senseless death while the hardened criminal in the next bed walks away from near death with malevolence in their hearts, and managing the delayed grieving process that can accompany a patients passing.

With that being said, I think it may be as good of a time as any to try and get some sleep and calm my mind, so without any further a due, please read on and enjoy the rest of your morning!

With love,

Mj ❤



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