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How Doctors die. It’s not like the rest of us (2016)

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Re: How Doctors die. It’s not like the rest of us (2016)

#11
post #10

My mom struggled with lung cancer for two terrible years with cutting edge treatment, and died badly. My dad cared for her through that, and when his turn came five years later, he had no doubts. He refused all but palliative care and died in two months. What he saw once, a physician will see over and over ad nauseam. Having seen one of each, I'm not conflicted over which path I'd take.

Was it small cell lung cancer?

edit: for the remarkably special downvoters (stay classy HN) - that's the type of lung cancer my mother died from, in about 20 months time. You generally can't surgically remove small cell lung cancer. It was particularly brutal, with endless treatment attempts that were physically grueling and minimally effective. It's a highly aggressive cancer with a very low survival rate and few good treatment options. Accordingly, having watched her go through that, I can very much relate to what the parent said.

Re: How Doctors die. It’s not like the rest of us (2016)

#12
post #7

Related and very interesting read: https://slatestarcodex.com/2013/07/17/who-by-very-slow-decay...

Far, far, far down in the blog post at section III., the author says this: > I (and the doctors in my family whom I’ve asked) am pretty much like the doctors in the article. If I get a terminal disease, I want to wring what I can out of the few months of life I have left and totally avoid any surgery, chemotherapy, amputations, ventilators, and the like. It would be a clean death. It would be okay. > My big fear, tho…

Why would that be the big fear?

Re: How Doctors die. It’s not like the rest of us (2016)

#13
post #10

My mom struggled with lung cancer for two terrible years with cutting edge treatment, and died badly. My dad cared for her through that, and when his turn came five years later, he had no doubts. He refused all but palliative care and died in two months. What he saw once, a physician will see over and over ad nauseam. Having seen one of each, I'm not conflicted over which path I'd take.

On the other hand, my sister was told to put her affairs in order. She did the major surgery and the chemo, and just passed 10 years cancer free.

Odds of her outcome were something like 5%. She's well aware of how lucky she is.

Re: How Doctors die. It’s not like the rest of us (2016)

#14
Years ago, Charlie, a highly respected orthopaedist and a mentor of mine, found a lump in his stomach. He had a surgeon explore the area, and the diagnosis was pancreatic cancer. This surgeon was one of the best in the country. He had even invented a new procedure for this exact cancer that could triple a patient’s five-year-survival odds – from 5% to 15% – albeit with a poor quality of life.

Charlie was uninterested. He went home the next day, closed his practice, and never set foot in a hospital again. He focused on spending time with family and feeling as good as possible. Several months later, he died at home. He got no chemotherapy, radiation, or surgical treatment. Medicare didn’t spend much on him.

I am guessing that he had testing which determined it had spread and was terminal. It seems implausible that an otherwise healthy person would just pass up on a 15% chance of survival.

Re: How Doctors die. It’s not like the rest of us (2016)

#15

Years ago, Charlie, a highly respected orthopaedist and a mentor of mine, found a lump in his stomach. He had a surgeon explore the area, and the diagnosis was pancreatic cancer. This surgeon was one of the best in the country. He had even invented a new procedure for this exact cancer that could triple a patient’s five-year-survival odds – from 5% to 15% – albeit with a poor quality of life. Charlie was uninterested…

If I were given a 15% chance of survival (at best) where the most I could hope for was having a poor quality of life, I wouldn't be interested either. Even it at 2:1 it'd be a tough decision for me.

Re: How Doctors die. It’s not like the rest of us (2016)

#16

Years ago, Charlie, a highly respected orthopaedist and a mentor of mine, found a lump in his stomach. He had a surgeon explore the area, and the diagnosis was pancreatic cancer. This surgeon was one of the best in the country. He had even invented a new procedure for this exact cancer that could triple a patient’s five-year-survival odds – from 5% to 15% – albeit with a poor quality of life. Charlie was uninterested…

As a doctor, he'd understand more than most what a "poor quality of life" means.

Re: How Doctors die. It’s not like the rest of us (2016)

#17

Years ago, Charlie, a highly respected orthopaedist and a mentor of mine, found a lump in his stomach. He had a surgeon explore the area, and the diagnosis was pancreatic cancer. This surgeon was one of the best in the country. He had even invented a new procedure for this exact cancer that could triple a patient’s five-year-survival odds – from 5% to 15% – albeit with a poor quality of life. Charlie was uninterested…

[deleted]

Re: How Doctors die. It’s not like the rest of us (2016)

#18
post #7

Earlier quoted context omitted.

Far, far, far down in the blog post at section III., the author says this: > I (and the doctors in my family whom I’ve asked) am pretty much like the doctors in the article. If I get a terminal disease, I want to wring what I can out of the few months of life I have left and totally avoid any surgery, chemotherapy, amputations, ventilators, and the like. It would be a clean death. It would be okay. > My big fear, tho…

Why would that be the big fear?

I'm guessing something like e.g. Alzheimers or some other quality of life degrading, but not lethal, disease that makes life (not as) worth living, at least past a certain point in the progression of the disease. But because its not lethal, it won't take you out of your misery.

Re: How Doctors die. It’s not like the rest of us (2016)

#19
post #7

Earlier quoted context omitted.

Far, far, far down in the blog post at section III., the author says this: > I (and the doctors in my family whom I’ve asked) am pretty much like the doctors in the article. If I get a terminal disease, I want to wring what I can out of the few months of life I have left and totally avoid any surgery, chemotherapy, amputations, ventilators, and the like. It would be a clean death. It would be okay. > My big fear, tho…

Why would that be the big fear?

A quick death can be a mercy.

Re: How Doctors die. It’s not like the rest of us (2016)

#20
post #10

My mom struggled with lung cancer for two terrible years with cutting edge treatment, and died badly. My dad cared for her through that, and when his turn came five years later, he had no doubts. He refused all but palliative care and died in two months. What he saw once, a physician will see over and over ad nauseam. Having seen one of each, I'm not conflicted over which path I'd take.

My parents had a very similar experience. I feel your pain, and I agree with your choice
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