Reality is Stranger than Fiction
One of the residents told me a really sad story the other day. They always say that life is stranger than fiction. And working in health care, and the beginning and ends, and intimate middles of people's lives, that becomes abundantly clear. Reality IS stranger than fiction.
That said, this story made me really sad and after she'd told it to me, I wish she hadn't. So if you don't want it to fester in your brain like it now will in mine, consider yourself warned and skip down and read the post about Mary Poppins instead. That is fiction that is better than reality. Or go watch "Neverland" and decide to believe in fairies.
She told me about a couple who had been married well over 50 years. They were both in their 80s by the time she learned their story when she was in med school. They'd both become frail and fragile and didn't want to go on living. And didn't want to die alone.
They decided to overdose on some of the many medications they took every day. They took the pills together. I imagine images of an older more modern version of "Romeo and Juliet."
But the overdose didn't work--for either of them. The husband was able to put the wife out of her misery by strangling her. How you could strangle the person you have loved for most of your life, I don't know. Maybe that is one of the ultimate expressions of love.
He strangled her, but he was still alive. And alone. And very sick in the ICU. And now a murderer. An 80 year old widower who killed his wife out of love.
This is when the resident telling me the story entered into the picture. She said that two armed guards were always outside his room, and that as soon as he was released from the ICU, he would be taken to jail.
Our discussion that spawned this remembrance began with end of life decisions and doctor's part in them. With the power of medicine it seems like in situations such as this we should be able to help couples such as this so they wouldn't have to go through this nightmare of reality.
But on the other hand, who decides? We already flirt with playing God at times. Deciding on life/death. Who can we save? Who can we let go? Then who should we let go? Or save? And if the individual(s) decide they want to leave this plane of existance, who are we to stop them? Why do we think that it is okay to help them hang on to scraps of this life but not okay to help them leave it behind?
We learn about "autonomy" in our medical school ethics classes. It means that a patient is autonomous, or able to make his or her own health care decisions; and even if the medical team doesn't agree with them, if the patient is found to have DMC ("decision making capacity"), meaning he or she has understanding of the risks and the benefits or his or her decision, they can rightfully accept or refuse treatment.
It sounds clear enough, but try applying it to real life situations, like the one above. Imagine this couple had come to their doctor and asked her to help them die. That is their decision. But it is against the law to help them (except in Oregon--and even then they must be eminently terminal).
Or try applying it to the 20 year old girl who came in with what appeared to be a fatal liver abscess but refused treatement and left AMA ("against medical advice"). Should we strap her down and make her undergo the life-saving therapy?
That said, this story made me really sad and after she'd told it to me, I wish she hadn't. So if you don't want it to fester in your brain like it now will in mine, consider yourself warned and skip down and read the post about Mary Poppins instead. That is fiction that is better than reality. Or go watch "Neverland" and decide to believe in fairies.
She told me about a couple who had been married well over 50 years. They were both in their 80s by the time she learned their story when she was in med school. They'd both become frail and fragile and didn't want to go on living. And didn't want to die alone.
They decided to overdose on some of the many medications they took every day. They took the pills together. I imagine images of an older more modern version of "Romeo and Juliet."
But the overdose didn't work--for either of them. The husband was able to put the wife out of her misery by strangling her. How you could strangle the person you have loved for most of your life, I don't know. Maybe that is one of the ultimate expressions of love.
He strangled her, but he was still alive. And alone. And very sick in the ICU. And now a murderer. An 80 year old widower who killed his wife out of love.
This is when the resident telling me the story entered into the picture. She said that two armed guards were always outside his room, and that as soon as he was released from the ICU, he would be taken to jail.
Our discussion that spawned this remembrance began with end of life decisions and doctor's part in them. With the power of medicine it seems like in situations such as this we should be able to help couples such as this so they wouldn't have to go through this nightmare of reality.
But on the other hand, who decides? We already flirt with playing God at times. Deciding on life/death. Who can we save? Who can we let go? Then who should we let go? Or save? And if the individual(s) decide they want to leave this plane of existance, who are we to stop them? Why do we think that it is okay to help them hang on to scraps of this life but not okay to help them leave it behind?
We learn about "autonomy" in our medical school ethics classes. It means that a patient is autonomous, or able to make his or her own health care decisions; and even if the medical team doesn't agree with them, if the patient is found to have DMC ("decision making capacity"), meaning he or she has understanding of the risks and the benefits or his or her decision, they can rightfully accept or refuse treatment.
It sounds clear enough, but try applying it to real life situations, like the one above. Imagine this couple had come to their doctor and asked her to help them die. That is their decision. But it is against the law to help them (except in Oregon--and even then they must be eminently terminal).
Or try applying it to the 20 year old girl who came in with what appeared to be a fatal liver abscess but refused treatement and left AMA ("against medical advice"). Should we strap her down and make her undergo the life-saving therapy?
posted by S. at 10:08 PM
0 Comments:
Post a Comment
<< Home