Death and Dying II

In the archives of this blog, you can find many posts where I explore the process of death in a modernized medical era. I argue that perhaps the death most people envision for themselves is not the type of death that occurs in hospitals, intensive care units, and cancer wards. I want to try to balance that notion that we ought to do absolutely everything we can for everyone because I don't think that's the right way to do medicine.

Since having a grandparent in that situation, I have definitely found that it is easier said than done. This is the kind of argument which makes sense from a faraway lens, looking at economics of medicine or generalizations of intensive care or risks and benefits of interventions. But when it is staring at you in the face, when it involves someone you know, when it suddenly becomes real, I find that the situation becomes much harder. Rationalizations cannot quell emotion. I know perfectly well that the end of life my grandfather wanted is consistent with hospice values. But I cannot help thinking down the line of "what else can we push medically?" There is a large whiteboard with my grandfather's entire history, all the chemotherapies tried, all the lab values, and I cannot help dwelling, trying to make medical decisions even though I know the ethical and caring decision is to let all that go. So I am beginning to understand, to some degree, the internal conflict families feel when I approach them about a code status or goals of care or whether it is time to stop.