* * Anonymous Doc

Thursday, April 22, 2010

Another overnight, survived. Only a few more until this rotation finally, mercifully, ends.

I don't want to be a vegetable.

If I'm ever in a permanent vegetative state, I don't want my family to hold a permanent vigil at my bedside. They can be sad-- I hope they're sad-- but if there's no hope for recovery, I want them to treat it like I've died and move on with their lives.

There's a family that won't leave. This woman's never coming back, she has no real brain activity, she is, for all intents and purposes, dead. And they won't leave. They're asking questions about recovery and treatment-- there is no recovery, there is no treatment, she is not herself anymore, the person they knew and loved is gone. Day after day they come back. They take turns sitting with her, they hold her hand, they talk to her. It's understandable, it's heartbreaking, it's illustrative of the love they have for her. But it's killing them.

Contrast that with a family down the hall-- their son is in a coma, he may well recover, we have no idea at this point. We don't know how much damage his brain suffered, we don't have a prognosis, nothing. But the attending insists there is hope. There is a chance he will come out of it, there is something to cling to, there is hope. And the family wants to withdraw care. They want to kill their son.

The attending says we won't withdraw care, no matter what the family says. It's medically irresponsible. So at least there's some ethics in the system, you can't make irrational decisions to off your loved ones even if you're the health care proxy.

But this is what these days are like here. Patients clinging to what's left of their lives. Every story is sad, and after a short (too short) while, nothing means anything anymore. When everything is sad, when there's no hope for any of these people to actually go back to living "normal" lives, if they live at all-- what is the reward in this? I don't understand how the attendings can live normal lives when all they see is this. How can they go home and do normal things with their families when all they see at work is life support systems and grieving families? It's the opposite of taking things for granted-- it weighs on you-- okay, it weighs on *me*-- with this sense that life is so rare, that health is so rare, that every moment you're not struck down is a moment so lucky-- I'm paralyzed to do anything. I find myself so insanely vigilant now as I drive home, so insanely vigilant as I do anything, because I can't believe anyone can actually live to an old age and be healthy. I don't want to feel that way but I do.

Clearly I need sleep. Like two days of it. Except I have to be back in the hospital in 20 hours, so that's the max I'm going to get, minus eating. Hopefully the rest will bring me back to sanity.

1 comment:

  1. I think every doctor should think these thoughts. And I think the good ones do. But professionally it should make you fight all the harder to save life, and personally it should make you treasure each day. Life is short. The body is fragile.