— conflict of interest

Generally speaking, I feel like many physicians and (pre)medical students choose to pursue medicine to save lives and to keep others from feeling the same helplessness we once felt when we lost or watched a loved one suffer from injury or illness.

But, it’s not a physician’s duty to save lives.

It’s difficult to come to terms with, but there are two real examples I want to share with you.

The first is our Jehovah’s Witness patient who fell off a ladder while picking oranges and broke his thigh bone.  He had an uncomplicated surgery, but for whatever reason, his blood count fell to alarming levels.  He suffered from a fatal, but easily correctable problem, so we did everything we could to convince him to accept blood.

He refused.

Although it was difficult, I came to terms with his decision.  We wanted to save his life.  He wanted to save his soul.

Luckily, it worked out for the best, because he recovered without receiving a transfusion and was discharged yesterday morning.

However, with our next patient, the problem wasn’t a matter of religion so much as it was of preference: she could either adjust her diet and control her blood sugars or die.

She chose the latter.

Weeping, she begged us not to amputate her remaining leg just as ardently as we pleaded with her to take her diabetes medications as prescribed and to watch the amount of sugar she ingested.  Her sugar control was so terrible that she became blind in one eye, her vision was rapidly deteriorating in the other, and her kidneys were failing.

After her amputation, I visited her in her hospital room and to my dismay, found her drinking an extra large cup of McDonald’s orange juice.  She was repeatedly informed that she would only have months left to live if she continued her current diet and medication noncompliance.  When I asked her why she ignored our advice, she answered, “I only have one life.  I have the right to enjoy it.”

That was true.  What right do doctors have to impose our will onto our patients?

The duty of physicians is not to keep patients from death.  It’s to maintain their quality of life, whatever they decide that to be.

Learning that helping patients isn’t the same thing as saving them is one of the greatest and most upsetting truths physicians must come to face and one that I’m still learning to cope with.

Posted 1 year ago — 76 notes
 #me  #med school  #ross  #sad day  #:-(
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    must-read material
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