How Doctors Die (2011)

That was only the beginning. I received dozens of singleton bills for the co-pay amounts for dozens of separate procedures and tests, which each arrived in my mailbox over a period of seven months. Seven months of surprise bills for various different things they did in a period of a couple of hours. The charges totalled in the thousands. And of course, for each separate charge, I got mail from both the insurance company and the hospital.

The net effect being that I received nothing except doctors saying "we see nothing wrong" and being sent home. But I had to endure finding surprise bills in the mail, and doing the paperwork to pay and file them, randomly for the next seven months. Every one a reminder of how a system took advantage of me while I was down and couldn't answer for myself.

I felt betrayed, like could not one person have the sensitivity and take the time to let me rest somewhere and feed me food and gatorade or something? And no matter how much I wanted to move on from it and get on with my life, I still had to face the bills streaming in like randomized salt rubbed into the wound.

Lesson: Take outstanding care of yourself at all times without fail. Don't have medical problems. If you do, have amazing health insurance.

I've seen two grandfathers of mine on which absurd medical care was given: one was seriously ill and maintained as a living mummy for months (he did look as bad as people who were rescued from extermination camp at the end of WWII) and another who, while in coma, had a leg cut off although everyone knew he wouldn't wake up. Who the heck wants to wake up with only one leg when one know you'll die in the next few hours / days of terrible cancers that spread throughout the whole body?

It's precisely what this article is talking about because it's really what's going on.

People dying in an environment they're not familiar with, experienced things they never experienced during their whole life: broken ribs due to overzealous CPR, one leg cut off, tubes everywhere.

I've had a girlfriend who was a doctor and the sheer number of crazy situation like this she was describing were insane.

Believe me: this is very real and you probably don't want the statistics.

Because the probability that you will notice, the day your day has come, that you're missing one leg while feeling your ribs being broken is very far from zero.

But from where I sit, the dying doctors' point of view, as presented in this article, struck me as irrational.

Axiom: Being dead is better than being alive. Under all circumstances.

I personally believe this axiom, very strongly. I'd rather spit in the eye of death with my last breath than go quietly into the night.

It logically follows, then, that a treatment that has a 1% chance of working is better than doing nothing, if the latter has a 0% chance of working, no matter how extreme the treatment is.

Living longer, even in a state of constant extreme pain, is better than dying. Well, maybe dying peacefully would be less painful for my relatives, but again, I personally place a much higher value on my own life than my family's feelings of sadness or whatever.

The only question which remains is the validity of the Axiom. If this world is all there is, if when you die there isn't an afterlife or reincarnation or whatever...then the Axiom is clearly true.

If you have strong religious belief, then perhaps your afterlife is better. But only a perfect belief that you are headed to a better place makes it rational to give up. If you have a little bit of doubt -- if you're 99% sure you're going to Heaven but 1% of you whispers that maybe there's nothing and you'll turn into dust instead -- you still want to put off rolling that die as long as you can. Ditto if you're 100% sure there's an afterlife and 99% sure you've been good enough to get into Heaven, but 1% of you says that maybe Hell is where you're headed.

If your religion forbids suicide, and there's a chance that the Judge who will weigh your life will interpret not opting for the best available medical treatment as equivalent to suicide, then that affects your decision too. Although, to be fair, this cuts both ways: The suffering you cause your family by lingering beyond your time on Earth might count against you too. Literally "Damned if you do, damned if you don't." It's unclear enough that there should really be a few more commandments or something, to address all the corner cases.

It's easy to sit back and pontificate that you'd choose heroic medical treatment over whatever the alternative might be if you've never actually seen what that entails. It's a lot harder when you see that for most people, especially older people, it's an experience akin to being imprisoned and then tortured to death. A hospital is an awful place to spend the last moments of your life.