When asked during a recent ICU rotation if I was considering critical care as a subspecialty, I offended more than one person with my response: “No, I really don’t enjoy torturing old people.” Granted, that unfiltered comment came at the end of a long and sleepless 28-hour shift, but the sentiment holds true.
As doctors, we have a number of tools to assess quality of life in research. We use fancy phrases like “neurologically intact” to describe a survival outcome that we might be interested in: a life worth living. Sadly, though, these signifiers are all assigned retrospectively. No one comes to you when you are admitted to the ICU to ask what constitutes a life worth living in your world.
Too often, we as physicians come to see death as a failure. We see return of spontaneous circulation as a success even when we know the patient won’t walk out of the hospital. We sometimes see crashing patients as a challenge, and when we lose the war with their disease, this can feel like a failure on our part. The truth is that sometimes we are unable to resuscitate a patient, and other times we should not. When the best possible outcome is a quality of life that would be considered unacceptable to our patient, our obligation shifts dramatically to something we are much less comfortable with than running a resuscitation.
Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how.
No comments:
Post a Comment