18
doc • Spring 2016
Kentucky
Lexington Medical Society Essay Contest 2015: Active Physician
Dying as Desired
By Charles G. Ison, MD
“The day of my
birth, my death
began its walk.
It is walking toward me,
without hurrying.”
– Jean Cocteau, “Postambule”
We are all going to die. If one wants to
bet on a sure thing, bet on that cold fact. As
medical professionals, we all secretly believe
that we are helping our patients’ battle
death. We see ourselves as our patients’
indispensable allies in fighting a war that, to
It’s Friday
Night…
be blunt, they will ultimately lose.
Healthcare professionals must decide,
along with the patient and his family, when
care switches from curative to end-of-life
care. We also need to decide what constitutes a desired quality of life at its end. All
three parties, and society in general, must
decide on how to reconcile these two decisions with how much they will cost and who
will ultimately pay for them.
There comes a time—especially for those
with chronic, progressive health conditions—where nothing can be done from
a medical perspective to cure a patient or
improve her health. We may know at which
point that occurs in a given disease process,
but this does not mean that the patient or
her family are ready to accept this.
The matter can be explained as tactfully
as possible, but they may feel like they are
surrendering if they agree. Some may be
blessed with an abundance of hope. They
may be people of strong faith who are
expecting a miracle to change everything.
We are human: there is absolutely nothing
wrong with believing these things. These
people often become more accepting of
initiating end-of-life care as their conditions
deteriorate, but some may not.
Some patients and family members
are pessimists—or “realists” as they may
claim—who may be ready to give up on care
too soon. They should be tactfully persuaded not to stop looking for a cure for their
condition. Attitude is important, but it is not
the only factor involved in dying. Otherwise
quite a few people would be immortal.
At a minimum, the healthcare providers and the patient should decide together
when it is time for end-of-life care. One
hopes that the family would respect the
patient’s wishes in this case. If the patient is
Save the Dates
April 15
April
15
April 16
April
16
Two Great Events, One Great Speaker
Register at: Lexingtondoctors.org
Social, Food,
& CME
“ 5 Things Early-Career Physicians
Need to Know about Leadership”
What: Enjoy an informal evening of relaxing and socializing
with your peers in the beautiful atmosphere of the Signature
Club. Heavy appetizers and cash bar culminating with a
engaging leadership seminar geared toward early career
physicians.
W h o: Early-Career Physicians, Residents &
UKCOM Medical Students
W h e n : April 15, 6:30p.m. to 9:00p.m.
W h e r e : The Signature Club,
3256 Lansdown Drive, Lexington, KY 40502
Costs: No charge for LMS members
Approved for 1.5 hours AMA PRA Category 1 Credits
It’s
Morning…
Breakfast,
Fosteringsnacks,
Teamwork: How Physicians &
& Managers
CME
Create High-Performance, Close
Knit,
“ FNo-Drama
o s t e r i n g Healthcare
T e a m w o r kTeams
:
How Physicians & Managers Create High-Performing,
Close Knit, No-Drama Healthcare Teams”
What: Highly interactive leadership workshop for physicians
and their practice managers.
Who: All LMS Members
W h e n : April 16, 8:00a.m. to 12:30p.m.
W h e r e : Lexington Center(near Rupp Arena), Thoroughbred
Room 1
430 West Vine Street, Lexington, KY 40507
Costs: No charge for LMS members & their
Practice managers. Non LMS physician: $150,
Non LMS physician practice manager, $75
Approved for 3.75 hours AMA PRA Category 1 Credits
Speaker: Joe Mull, M.Ed., We are bringing
Joe back for a third tme due to raving
reviews by our members. Joe is the former
head of Learning & Development for
Physician Services at the University of
Pitsburgh Medical Center.