How Doctors Die • Hacker News Board

Re: How Doctors Die

#51

Post by Jach » Mon, Dec 05, 2011, 12:38 PM UTC

VMG wrote: post #19

One alternative that hasn't been mentioned here is cryopreservation. Once I have the resources and the technology has progressed, I'd certainly choose that option above being treated and "NO CODE".

Totally on board with cryonics, it's really depressing that it gets swept under the rug considering it probably has at least 5% chance of working for a patient suspended today. Though your excuses for presently avoiding it seem pretty flimsy unless you're really dirt poor (I'd wager unlikely), especially when life insurance payable to the cryonics company is cheap (you only need $28-$35k for CI) and so are membership fees ($120/yr or $1,250 once for CI; I spend more than $120/yr on fast food). But don't get upset, my excuses for not being signed up yet are pretty flimsy too.

Re: How Doctors Die

#52

Post by vacri » Mon, Dec 05, 2011, 12:40 PM UTC

mfringel wrote: post #48

vacri wrote: post #41

Earlier quoted context omitted.

How bizarre that they'll accept 'do not resuscitate' on jewellry, but not tattooed across the chest. "Do we think he really meant it? Nah, he just got the tattoo - if he really meant it, he'd be wearing one of those constantly annoying bracelets"

What if "NO CODE" is the name of a band? You're asking someone to make a quick life-or-death decision on ambiguous data when there is a clearly known and socially agreed upon way to express the sentiment. Having it on an annoying bracelet that is explicitly used to signal medical intent sounds pretty good to me.

So what if "NO CODE" is the name of a band? I'm talking about "Do not resuscitate" - and if you tattoo that on your chest because it's a cool band name, you're an utter fuckwit. 'No Code' is stupid anyway because not everywhere uses that jargon, while 'do not rescuscitate' is clear, plain English.

As for the bracelet, I hate jewellery and anything from my elbows down catches on anything that I'm working on with my hands, and I'm not alone - and unlike the tattoo which is only 'present' at parts of the day, a bracelet is always 'present'. Not to mention that there's all sorts of medical accoutrements that infirm people are supposed to carry with them but don't because they're annoying (prime example being the 'help, I've fallen' pagers).

Re: How Doctors Die

#53

Post by ams6110 » Mon, Dec 05, 2011, 12:43 PM UTC

rdl wrote: post #16

dcurtis wrote: post #6

I was in Best Buy earlier today and the sales guy who was trying to sell me a TV reminded me a lot of the doctors/residents I was dealing with during a few weeks I spent caring for a family member at Mass General Hospital a couple years ago. I don't think they do it consciously, but doctors try to sell you on their philosophies for healthcare. But it doesn't matter. You're sitting in a small room with dim lights and…

I can't imagine not doing #2 unless I'd also be non-functional during the extended life period. If I could read, use the Internet, write, talk to people, etc., it seems like it would be worth pain (which will end when you die, no matter what). The only case where I could see #1 being a reasonable choice is if #2 puts such hardship on those around you that their lives become much worse.

Nobody gets out alive, so for me it's definitely a question of quality not quantity. It's all very case-by-case however; for example my dad had major surgery to remove most of one of his lungs (cancer) and recovered and had another pretty normal decade of life before the cancer returned, at which point in consultation with his doctors he decided he wanted nothing more done. He could have had more surgery, chemo, radiation, but was clearly in the zone of diminishing returns (enduring a lot of unpleasantness for maybe a bit longer life of uncertain quality).

Re: How Doctors Die

#54

Post by andrewmu » Mon, Dec 05, 2011, 12:49 PM UTC

vacri wrote: post #40

defdac wrote: post #21

Tonight I will tell the mother of our child that if I reason in any way that resembles this article she should slap me in face and tell me to fight for my life. For my daughter and my own sake. In Sweden medical care is free. I can fight as long as I want without them getting in trouble. I also suspect I should fight so hard as if the illnes is truly terminal I will end sooner in flames, not later. I want all the tub…

Telling people to give up because of money or some sort of gentleness to yourself or your family is alien to me. Maybe it's our harsh climate uphere. Swedes seems very in tune with our suffering. It's not about being tough and macho. A lingering decline can be psychologically painful for everyone involved. Pretty much everyone I know that has been involved in caring for someone who suffered a slow decline - particula…

A lingering death can sometimes be easier for those round about you, to some extent. They know what's happening, get a chance be resigned to the future, but still talk to you before the end. And if it's painful, they can feel relief that your suffering is over.

When you die quickly, you personally don't suffer, but those around you are stunned by the sudden, often unexpected loss and life. It seems cruel and arbitrary.

Re: How Doctors Die

#55

Post by kghose » Mon, Dec 05, 2011, 12:50 PM UTC

Some people on this thread have harped on cost (and used it as a way to insert their own agenda about the economics of healthcare) but from my reading of the article it is really about being free to make an informed and personal choice about what the cost/benefit of treatment in terms of life quality vs life quantity is to you.

It is true the writer writes from the point of view of his own choice, but on a topic such as this, that is really the only way to do it authoritatively.

The point of the article, I thought, was to make us think - what would I do when/if the time comes?

Re: How Doctors Die

#56

Post by conorh » Mon, Dec 05, 2011, 12:59 PM UTC

My wife is a surgeon and sees these situations constantly, a patient whose family has asked that everything be done for them. They spent months in the ICU hooked up to machines, incredibly uncomfortable and often, if they are aware, extremely depressed. And then they die. This is traumatic for everyone involved.

She (and I) would never go through this by choice. I can't stress that enough. This is not about money, this is about leaving life in the best possible way, on your own terms, with your family and as comfortable as possible.

Re: How Doctors Die

#57

Post by msimonovic » Mon, Dec 05, 2011, 12:59 PM UTC

http://xkcd.com/936/

Re: How Doctors Die

#58

Post by budley » Mon, Dec 05, 2011, 1:06 PM UTC

vaughan wrote: post #46

defdac wrote: post #21

Tonight I will tell the mother of our child that if I reason in any way that resembles this article she should slap me in face and tell me to fight for my life. For my daughter and my own sake. In Sweden medical care is free. I can fight as long as I want without them getting in trouble. I also suspect I should fight so hard as if the illnes is truly terminal I will end sooner in flames, not later. I want all the tub…

Here, here. I'm from Australia where medical care is also free. This idea of dying quickly as to not burden your family with medical expenses is ridiculous, given the success that single-payer health care has had in many countries all over the world. I understand that some conditions cause insufferable pain with very slim chances of surviving, but there are many success stories from people who have battled through. I…

It's not free, public hospitals are overcrowded and full chemo etc costs a lot. Fight to your last breath if you want to but the point of this article is that doctors themselves think that on average you will be happier living your final days without extreme treatment. All the miracles you've heard of are effected by reporting bias.

Re: How Doctors Die

#59

Post by kalid » Mon, Dec 05, 2011, 1:09 PM UTC

dcurtis wrote: post #6

I was in Best Buy earlier today and the sales guy who was trying to sell me a TV reminded me a lot of the doctors/residents I was dealing with during a few weeks I spent caring for a family member at Mass General Hospital a couple years ago. I don't think they do it consciously, but doctors try to sell you on their philosophies for healthcare. But it doesn't matter. You're sitting in a small room with dim lights and…

Humans are notoriously bad at predicting what will make them happy.

Re: How Doctors Die

#60

Post by gnaffle » Mon, Dec 05, 2011, 1:10 PM UTC

defdac wrote: post #21

Tonight I will tell the mother of our child that if I reason in any way that resembles this article she should slap me in face and tell me to fight for my life. For my daughter and my own sake. In Sweden medical care is free. I can fight as long as I want without them getting in trouble. I also suspect I should fight so hard as if the illnes is truly terminal I will end sooner in flames, not later. I want all the tub…

Medical care is free, but it too has a limit. There is a finite amount of money available for treatment, and there is an almost infinite amount of new, unproven treatments that might just work.

Lots of people put themselves into debt trying alternative or experimental therapies, even in countries with universal healthcare. The sad truth is that whatever kills you will probably not be something that the doctors can learn much from. It will be some disease that is well known, with lots of data on survivability etc.