Tag Archives: CPR

Doctors are Just Glorified Theatre Ushers

I’ve made this contention on several occasions and always get the same head cocked confused half nervous chuckle.  “Dr Brian, how do you figure?”

In my practice I see all ages but mainly geriatric patients.  There  is no end to the amazing diversity of discussions, questions, and odd request that I get from my patients and I attentively try to manage each and every one.  I love tackling the enigmatic diagnosis and the satisfaction of relieving someone’s acute symptoms.  The challenges of dealing with family dynamics and patient insight is always interesting.  I take special pride and honor that Patients trust me and often will call me first with problems and extremely personal issues.  They give me the most intimate insight into their lives.  A trust and honor that will always make being a doctor a most sacred of professions.  After all, doctors are the nosiest people I know.

But day in and day out, my job is pretty routine and basic.  I rarely heal people (that’s patients and nature), I just keep them busy while their bodies do all the real work.  I have thought this for a long time but have really never known how to say it just right.  However, at the blog Musings of a Dinosaur (http://dinosaurmusings.blogspot.com/) I think she said it better than I with her 1st Law:

“The art of medicine consists of amusing the patient while nature takes its course.”

I’m always  just buying time and trying to keep the patient comfortable and calm.  Following my own personal 1st rule: DON’T PANIC.  No matter what you do, that is ALWAYS the first rule.  I believe this so much that my kids, when asked what’s the first rule will always respond in a monotone unison,” Don’t Panic, dad…”  Keep people calm and comfortable and more importantly, distracted. 🙂

I digress and must get back to the reason of this blog.  How is a doctor like a theatre usher?  All this day to day care of patients is not the most important and satisfying part of my job.  That position is firmly held by two things, Birth and Death.  Nothing in all of medicine is more fulfilling, amazing, or spiritual than helping to bring a life into the world or to leave it.  I do not mean euthanasia before anyone sends me hate mail.  I mean the process of comforting physically and emotionally the dying.  Standing there at the bedside as someone drifts to eternity and pulls the last bits of air from this world.  Due to a malicious and unreasonable malpractice system, I have been robed of delivering babies.  Something I just have to accept.  Thank heavens I’m still allowed to help the dying.  It is the greatest of honors to share in a patients death, especially when it is a good death.  Every human dies and only once.  When done well, the experience is out of this world.

So, how are doctors like theatre ushers?

My job is to usher people into the show.   Help them find their seat and to keep order and calm so they can hopefully enjoy their show.  I don’t have anything to do with what show they see.  It may be a short film or a marathon epic.  It may be a comedy, horror, or amazing love story, but in the end I just try to keep people comfortable during the show.  I cant stop them from leaving early, I cant stop others from ruining their experience.  I simply use my little flashlight to look for signs of problems and deal with them as best I can.  More importantly, when the show is over I gently show them the door and clean up the mess afterwards.  After all, we have many more showings to do.

So please remember, the doctor cant fix your life.  They can only help make it more tolerable.  They can not save your life, they can only allow you to stay till the end of the credits.  You eventually will still have to leave the theatre when the lights come up.

Enjoy it and above all…. Dont Panic.

 

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Zombies!!!

Zombies are real.

We create them everyday in hospitals and medical facilities all across this country.  Not in sinister basement labs or secret government facilities.

But they are real.  Dead humans, brought back to life to be brainless, rotting, eating machines.

For as much horror as Zombies invoke, I am amazed at how easily people often allow this Zombification to be performed on their own loved ones.

Now let me be clear.  Doctors, nurses, and other healthcare providers try to warn people and often work hard to avoid the zombification procedure from being done but it is often futile as families ignore this professional advise and will even insist that the procedure be done at all cost.  In some cases, when families and patients are not satisfied with the first zombie procedure, they will insist that it be repeated over and over again.  With each procedure the chance of full fledged zombiehood  increases to the point that it is an almost certainty.

Certainty that the patient will be left a brainless existence and lay rotting, moaning, and wallowing in their own filth with nothing more to do than feed.

At this point in the post I am certain I have lost a few readers (either in disgust or in contempt for my ridiculous notion) but hear me out.

The way Americans approach end of life care is atrocious.  Our society is immature and uneducated about one of the most basic truths of life.  The truth that we all die.  Also the truth that we are meant to die and pass this world on to our children and grandchildren (hopefully better than when we got here but that’s debatable and a whole different post.)  Modern medicine has given us remarkable tools to improve and sustain life but often these tools are used excessively with little real benefit to quality of human life and existence.

Dr Ken Murray recently posted an excellent blog, Zócalo Public Square :: How Doctors Die. In which he explains that doctors themselves rarely use the full extent of modern medical capabilities toward end of life.  Why is this?  Doctors have spent a life time in the study of life and with this, they are comfortable with death.  Not only are physicians comfortable with death, we know that people can (and often do) die BADLY.  Doctors want to have “The Good Death.”

When they see that time of death approaching and if given the opportunity, they will usually welcome the good death and refuse aggressive medical care.  Medical care that will only lead to complications, pain, and suffering in the last days.

So if this is what most doctors want for themselves and recommend for their families, then why not for their patients?  I can go into a long soapbox of how lawyers, politicians, doctors, patients, etc. etc. have all poisoned the system and the doctor patient relationship, but I wont.  The answer is in each and every one of us.  The whole U.S.A society.  We all share the blame that we have glorified life and demonized death to the point that accepting death under any circumstance is a sin.

And what do we have to show for it?

GGggrrUgghhh….. Brains!!!