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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)

#71

Post by girvo »

lsaferite wrote: post #26
classichasclass wrote: post #10

Earlier quoted context omitted.

"Early" is load-bearing. Even brief delays, just mere minutes, significantly decrease survival or positive outcomes. https://www.ahajournals.org/doi/10.1161/CIRCOUTCOMES.123.010... It's important to get people to realize the benefits of early CPR and more people should be trained on how to do it, or else it won't be prompt and the outcomes will be worse. That's what the Red Cross and AHA promulgate to the public, in…

I've never heard the term "load-bearing" used outside of the civil engineering world until the more recent versions of Claude suddenly decided everything was "load-bearing". Did you internalize Claude terminology, use Claude to write/translate your post, or lead Claude into temptation by being the OG? Asking out of genuine curiosity and not at all trying to throw shade.

It's funny you're being grumped at about it, but yeah "load-bearing" outside of civil eng is my "nails on a chalkboard" slop signal. Well, one of many.

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

#72

Post by throwawayk7h »

____tom____ wrote: post #25

On the spectrum or go gentle vs fight, I'd have to say, now is the time is history where "fight" makes the most sense. This is not abstract for me. I have not one, but two forms of cancer. Both were considered incurable when I was diagnosed. Both have treatments now that, IN SOME PEOPLE, lead to remission. I still don't know which group I am, but I'd be dead from either one by now, if I hadn't elected to treat. New t…

if nothing works, try cryonics. Maybe AI-2040 is right and we'll be able to revive you in a few years.

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

#73

Post by bruce511 »

____tom____ wrote: post #25

On the spectrum or go gentle vs fight, I'd have to say, now is the time is history where "fight" makes the most sense. This is not abstract for me. I have not one, but two forms of cancer. Both were considered incurable when I was diagnosed. Both have treatments now that, IN SOME PEOPLE, lead to remission. I still don't know which group I am, but I'd be dead from either one by now, if I hadn't elected to treat. New t…

Lots of people will take any treatment offered. Indeed I would. That's a perfectly acceptable approach.

Yes, medical treatments are improving and hanging on is a good approach cause something may be around the corner.

I don't think the article is advocating for no treatment ever.

I think it is advocating for a balanced understanding of what treatment looks like, and balances that with quality of life. And indeed balances your age as well.

If I'm 80, I'm (somewhat) less concerned with length of life, and more concerned with quality. If I'm 50 that's a different equation.

It's very much a personal choice, but to make a choice you have to have information. And it's helpful if you can make the choice in a calm relaxed environment. Both can be missing immediately after hearing a diagnosis.

The point is that medical intervention is usually desired. But equally there's a place for acceptance and contentment.

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

#74

Post by stavros »

____tom____ wrote: post #25

On the spectrum or go gentle vs fight, I'd have to say, now is the time is history where "fight" makes the most sense. This is not abstract for me. I have not one, but two forms of cancer. Both were considered incurable when I was diagnosed. Both have treatments now that, IN SOME PEOPLE, lead to remission. I still don't know which group I am, but I'd be dead from either one by now, if I hadn't elected to treat. New t…

Give us an update in twenty years please.

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

#75

Post by shellfishgene »

j-conn wrote: post #3
ggm wrote: post #2

> Many people think of CPR as a reliable lifesaver when, in fact, the results are usually poor. I’ve had hundreds of people brought to me in the emergency room after getting CPR. Exactly one, a healthy man who’d had no heart troubles (for those who want specifics, he had a ‘tension pneumothorax’), walked out of the hospital. This point has been made by many medically trained people over decades. It's a very energetic…

Totally misleading. Early CPR (+AED if available) absolutely saves lives. Article is from 2011 by a family med doctor. Overly aggressive resuscitation attempts are definitely a problem but context matters

What are the statistics for quality of life after CPR even if it saves the patients life? I think this is more what the article is about.

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

#76

Post by stavros »

thejazzman wrote: post #34
2bitencryption wrote: post #7

Earlier quoted context omitted.

> It's a very energetic intensive process, it cracks ribs. I feel like lately this is becoming more common knowledge - but still something most people don't realize. Part of it is probably the fact that it's impossible to depict "real" CPR in popular culture (movies, TV shows, etc) unless the production goes to extreme lengths to use a fake dummy. Even on The Pitt (which seems to make a point of being hyper realistic…

so on Lost when Jack is really upset about Charlie, and he beats the shit out of his lifeless body, ... and it worked, did he do real or fake CPR? These comments make it sound very real.

Fake. You can't have fire without oxygen, but that doesn't mean you can't have oxygen without fire. Breaking someone's ribs doesn't necessarily mean you're performing CPR.

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

#77

Post by tpoacher »

This article is making a LOT of "convenient" assumptions.

For all we know, the more likely scenario is that Charlie, like a sizeable percentage of his doctor peers, was burnt out, tired, and depressed, did not really have an overwhelming (some might say "healthy") desire to survive (in fact, perhaps quite the opposite), and saw the cancer as a non-undignified quick "way out".

Doctors (and medical professionals more generally) rank among the highest in occupational risk of mental health disease, especially for things like addiction, alcoholism, generalised anxiety, ptsd, depression and suicide.

I have no objection regarding the choice he made, but let's not glorify it as the "natural" thing to do either. This narrative is harmful to people who "do" desire to survive but are scared, which may then prevent them from making a dispassionate decision regarding their care.

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

#78

Post by cowthulhu »

Alien1Being wrote: post #69

Last week one of my patients with preterminal NYHA Stage IV cardiac failure looked into euthanasia. He found predictably that it is now legal in my country but takes months and formidable legal resources to obtain it. Legalisation of euthanasia has, as everyone in the field warned multiple times, made it much harder to obtain and now requires a lot of time, effort and money. The well meaning, naive proponents of lega…

If I’m understanding correctly, it was already quasi-legal through a loophole, but formally legalizing it made the loophole much trickier to use? That does sound frustrating. I hope they simplify the legal rails… having to wait around in pain waiting for multiple rounds of paperwork to clear sounds terrible.

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

#80

Post by LaurensBER »

tpoacher wrote: post #77

This article is making a LOT of "convenient" assumptions. For all we know, the more likely scenario is that Charlie, like a sizeable percentage of his doctor peers, was burnt out, tired, and depressed, did not really have an overwhelming (some might say "healthy") desire to survive (in fact, perhaps quite the opposite), and saw the cancer as a non-undignified quick "way out". Doctors (and medical professionals more g…

This is an interesting point and the article should definitely take these factors into account.

It's indeed very worrying what we ask medical professionals to put themselves through for their jobs. I think we can all agree that having a well rested doctor or nurse would be preferable over a stressed/tired one. The amount of hours and night shifts that (young) doctors have to do and the extreme competitiveness of the field (partly) drives this.

I understand that it would drive wages down (somewhat) if we educated more doctors and obviously we shouldn't lower our standards substantially but it seems like everyone involved would benefit from this.

A friend of mine, whose a doctor, told me once that the best way to ask for medical advice is to ask the doctor what he/she would recommend for their own sister/brother. Siblings are close enough that he would not want them to suffer unnecessarily but it eliminates the personal factors. Obviously it differs per doctor but in my experience it usually leads to a good conversation about the trade-offs for medical care.

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