I haven't been writing in here lately mostly because I've developed what seems like an all-pervasive apathy towards my work. Which sounds bad, because shouldn't this be the most exciting part of my career - the part where I take off as a fully fledged attending? Instead all I feel is....well....nothing.
Except the occasional burst of frustration and anger because I forget that my patients aren't as medically savvy as I am (obviously). And because when the shit hits the fan I can't talk reason into some of them. And because I have been running up lately against people who simply don't know how to fade gracefully.
The Western world's preoccuption with life - with life at all costs - is something I doubt I'll ever understand. I'll never understand why people insist on having things done to them to preserve their lives while sacrificing the quality of their lives for a vegetative state. Why don't these people understand how to go gently? Actually let me correct that. It's not the patients that don't know how to do it. It's their families.
There is nothing worse than doing something completely futile to a patient and causing them more distress and suffering and doing so without believing at all in what I'm doing. Doing it because their families are unable and unwilling to ignore their own personal grief in favour of their loved one's wishes or desires. Over and over I have run into this. "Mum would never want that," they say, "but I'm not ready to let her go."
Don't they get that it's not about what they want, nor about whether they are ready?
Instead I feel helpless and I feel forced to act against what I believe in. Mostly because I am afraid of being sued. Because I can't stand in court and have no stomach to do so and defend the reason I did not intubate that 97yr old patient who was in respiratory failure, or explain why I refused to perform CPR on that 88yr old patient with metastatic cancer who arrested at home.
Death is a part of life.
A society that doesn't understand that - I find myself disgusted and unwilling to be a part of this.
But maybe I'll learn... I hope I do... if only because my career would otherwise be shortlived.
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You should read Conversations with God. Or flip through it (Book 2, I think) at a bookshop. Nothing religious. Just that the book tackles this topic :) I agree wholeheartedly. It's just sad that the medical profession has be trained and pledged to save lives rather than let people die with dignity.
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