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.