While death is highly personal, health and illness are social. Both affect those around us, sometimes perhaps more so than they affect us. As a mom, I think about health, illness and death, probably more so than when I was young, single and childless; I am sure many of you do the same. When I consider my own death, it is always with respect to how it would affect my children or my husband. That is why I was intrigued by an article published on Zocalo Public Square, entitled How Doctor’s Die.
The article, by Dr. Ken Murray, a Clinical Assistant Professor of Family Medicine at USC, details a vast disparity between how physicians and non-physicians or patients approach terminal illness and death. Dr. Murray suggests that many physicians, having seen death, having seen terminal illness and having seen the pain and suffering associated with many end-of-life treatments frequently choose a quiet death, unaided by lifesaving heroics. They choose to live, what life is remaining, with family and friends. In contrast, patients and their loved ones often grasp for every medical miracle, sometimes increasing pain and suffering for themselves and their family members along the way. Many patients, it seems, fight for the medicalization of death.
It may not be that simple. The comments posted following Dr. Murray’s blog suggest a myriad of responses, some none too polite. Research on the topic also suggests a bit more complexity than the doctor-patient dichotomy presented. In a recent study published by the Archives of Internal Medicine researchers found that when physicians were faced with a hypothetical terminal illness they were statistically more likely to take the riskier treatment themselves than recommend it to the patient. Indicating that physicians may fight more stridently for the latest, life-saving medical technologies.
Or it could be that when physicians face terminal illness, hypothetical situations aside, they are just as ‘irrational as the rest of us’ says former terminally ill patient and physician Eric Manheimer. While Dr. Manheimer wanted to cease treatment, his wife would have none of it and convinced him otherwise. He survived to tell about it. Maybe when it comes to illness and death, rationality has nothing to do with the decision-making process. Maybe it’s all about personal choice and personal choice is, more often than not, guided by a host of factors, including emotion.
I wonder if this holds true in life and health. Do physicians take the medications they prescribe to their patients or do they seek alternative treatments? Or do they ignore their health altogether like so many of us do? Do physicians approach surgical options in the same manner as patients? Does this unique and daily perspective of illness and death change one’s view of life or health? It must. How could it not? What do you think?