Monday, 30 April 2012

Prolonging death or extending Life?

In the article "Heroic measures cannot cure how people want to live their lives" Dr. Angienadia expresses a crucial issue that I believe that most physicians may come across in their career. Should a line be drawn for those patients who continue to damage themselves even after treatment? When "heroic" measures committed by doctors such as Dr. Angienadia are not enough then what hope is there left for the patients who refuse to either take treatment or stop their unhealthy lifestyle? I can not even imagine the frustration that these physicians must undergo when their patients return to the hospital because they just simply refuse to listen. As a premed student, I believe that Dr. Angienadia is correct in saying that in some way doctors are only prolonging the death of these patients. However, as a family member, I see these heroic acts as a way of extending life.

My uncle has been diagnosed with Parkinson's disease a few years ago and his symptoms have been gradually getting worse. Doctors said that if he took his medication every day, then his hands would not be trembling as violently as they do now. When I visited Korea a few years ago, I had dinner with him and at first glance he seemed to look normal. He was very thin and pale but other than that there was no shaking. Midway through dinner, he got up and walked towards the bathroom and it was then I understood everything. He purposely sat on his left hand to stop it from shaking and when he was walking, he desperately tried to hold onto his left hand with his right. After dinner, all the adults begged him to take his medication or else he would have to go through surgery again. He already lost his job and his relationship with his family was beginning to deteriorate. My aunt would discuss how his symptoms got better after visiting the doctor and this gave him a brief window of opportunity to think about what he could gain from his medicine. To my aunt, these brief moments meant the world to her. It was a time when her family could resume the life that they had before.

To some doctors, patients like my uncle may be seen as a resource waster. These pills are expensive and my uncle barely takes them. Time is of essence in hospitals and treating a stubborn patient may in fact put another patient's life in danger. Logically, if a doctor could save ten patients in the amount of time it takes to convince my uncle to go through surgery then it may be rational to, as Dr. Angienadia says, draw a line for my uncle.

I respect what doctor Angienadia does and a mere student like me could have no idea the pain that she and all the other doctors go through in order to improve the health of those in need. It would be out of my place to tell any doctor to have patience. But despite knowing all this, I feel that it is out of any doctors place to just say "you do not get a second chance at life". Do doctors, in the midst of all this stress and frustration, lose sight of how family members feel about this second chance? Maybe Microsoft excel might illustrate with solid numbers that one is operating at a loss and that these resources are better spent elsewhere. However, the family members of the patient may not view these solid numbers with the same rationale as the doctors do. As disheartening as it is for me and my family to look at these numbers we want our uncle to live in the hopes that we will be able to persuade him to choose a better path.
 I do not condemn the idea of doctors being efficient in order to save a greater number of people. I realize that I am the selfish one for risking the life of others who may cooperate and show greater progress. However, in order to be efficient does one have to give up emotion to be rational?

After careful consideration, I have come to the conclusion that doctors will not be able to do their job properly if they had to contemplate about the emotions of every family member. Being logical does not always imply a lack of emotion. Sometimes being rational is the strongest way to illustrate that the doctor cares and that he or she is trying their best to save as many lives as possible. Lives are at risk and the stubbornness of one patient should never cost the lives of others. But as a doctor, one should always try their best to help the patient in any way possible. It should not be a matter of "should I give this man a second chance at life" but "in what other way can we tackle this problem" as med schools always emphasize the importance of problem solving.

Thank you for reading!

Please read Dr. Angienadia's insightful article at the link below:

Mission Statement

Amateur Reviews of Medical Journals is a blog that I created in response to a journal that I red on After reading articles written by physicians, and learning about their views on a variety of important and emotional topics, I felt that I could better organize my thoughts about these articles if I blogged about them. Some of my colleagues have started blogs of their own and I saw how blogging gave them the opportunity to not only express their opinions, but also receive open feedback from a variety of other people using the power of Facebook.

Although it would be amazing to receive the critiques and opinions of others, I just want "Amateur Reviews of Medical Journals" to be like a personal diary of mine. I am someone who has trouble organizing my thoughts and from time to time I would lose hold of an interesting idea and that frustrates me to no end. Hopefully, this blog will help me preserve all sorts of ideas so that maybe in the future at least one of them will help me figure out what my true passion is. The title does state a review of medical journals but I will write about many different topics, even video games, because honestly I just want to have fun with this.

Hyun Nam