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Some sex irrelevant thoughts about patients


Sharp-edge

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Thanks for this response, BootmanLA !!!

I am always saddened to hear about arrangements that never were made.  Understand, everyone - this is a stressful situation when it comes, and it's so easy to be prepared, rather than have to roll with the punches.  Even when every eventuality is prepared for in advance, it's no "guarantee" that the documents will be read unless the person in duress has an advocate present to insist - or demand - that the documents are available and read by any potential attending physician.  

I've never understood why so many people are so afraid of making their plans / arrangements well in advance of the likely time they'll be needed.  Why risk just allowing events to overtake you - or a loved one - by not being proactive in making your wishes binding, cast-in-concrete, ready when they're needed?  It's so easy to plan ahead for what will inevitably happen to every single one of us. We're only here temporarily, regardless of how long we live.  

1.  If you don't have one already, find a law firm specializing in "contract law", and then retain them.

2.  Meet with one or more of the attorney's at that firm, and they will help you make decisions, enshrine those decisions in legally binding documents, and (in some cases) stand with you if necessary.  

3.  Give copies of these wishes to your internist, a hospital you're likely to be taken to in an emergency, and a couple of friends or relatives you trust.  Even if you live alone, one or          more of these people will be in a position to advocate for your wishes, even if you're not.

4.  You can always make updates, as the years go by, to meet different circumstances.  

Since I'm not a lawyer, and since I live alone, I've done all of these things, to make sure my departure is as reflective of my wishes as I possibly can.  Once we're (literally) done for, it doesn't matter all that much, but until we're actually outta here, it can matter a helluva lot.  Even if you're only middle-aged, it's a good idea to at least have a will drawn up while there's no question of "intellectual ability" able to be questioned by asshole relatives left out of your will.  Or, you may want to make it really crystal clear to any asshole relatives, by leaving them one single dollar.  $1.00   That proves that you were of sound mind, didn't "forget" them, blah blah blah.  And, it will make you smile every time you have to interact with them, imagining their reactions when they find out the bitter truth !!!

Bring proactive is good.  Being an ostrich (head-in-the-sand) is not.  

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On 4/2/2022 at 6:56 AM, Sharp-edge said:

But sometimes, you get to get the patient back.

Yes, sometimes we do get the patient "back", but that's not the crux of the issue. 

"Back", but with what ability to continue some measure of quality in the rest of their lives?  "Back", just to lie in a facility somewhere?  If those decisions aren't made, then carved in stone, chances are just as good as not that their "quality" of life will be substantially diminished.  Who gets to decide?  The physician?  The family?  The lover/husband/life-partner?  

WE get to define what happens to us, in our persons, and in certain circumstances, if we take the important steps in advance.  

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Good morning ....

You've done an admirable job of presenting "the other side" of the issue - not as part of the problem - but an authoritative voice experienced with the other side of the coin.  

You also understand the perspective of a patient's loved-one, that is duly authorized to make required decisions, and feel empathy for that person in distress.  

How indeed, do we "humanize" the Medical Machinery of the Health-care system?  You know a lot more than I ever will about the problem, and I hope some progress can be made.  I'm not that bad at composition, so if there's some recipient that might need to hear from me - as a concerned citizen - I'll gladly write a clear, polite, and unmistakable letter.  

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  • 3 weeks later...

Let me bother you with some more thoughts 🙂

I've completed my training in the ICU, now i'm somewhere even worse, in the morgue. Which is kinda awful, traumatising, disgusting and most of all.. odd. That would be the most correct word. I feel like it's in another dimension. The same would be true for the ICU, so it's just another world in the most literal and metaphorical sense.

My thoughts can't stop knocking on my mind's door. Who would ever ever want to be in this job? That's the first thought of everyone. It's so sad and shocking. I am there for two weeks and I have 3 more. The dead bosy is so creepy, at least to me. I don't want to be anywhere near, i'm kinda obliged though. It's not even close to the bodies we had during anatomy. So many thoughts. Were they in pain? How I should feel when I'm there? Are they really dead? I'm kinda scared of the dead, is it childish? We had a guy who had been murdered but he's face was intact. His eyes were blue and wide open. I was staring at him. I was thinking if he was in pain, if he was sad, if his gf/parents/anyone found him like this. Why should anyone kill that (or any other) guy? My heart ached. I think this job makes you sadder and sadder. But I'm pretty sure there must be an exceptionally good reason that someone studied medicine, surpassed the fear of the dead and chose to work with their bodies. 

I think that maybe it's because you fulfil your final debt to a person. Reveal the truth. Was he murdered or was it an accident? You must not miss that clue, you must serve justice and ensure the truth reaches the right ears. Don't let him be murdered, don't let someone get away with it. That's some thoughts I'm having.

And some final thoughts. I know they don't feel cold, or anything but I somehow need to feel that they feel comfortable. Somehow, even in the slighest move respect must be maintained and granted. You touch his dead body, you have to treat it like it's something of utmost importance. I also feel that they are "annoyed" by being left in the morgue. They need to be buried,  to be returned back to the soil where the circle of like will begin a new. Decompose and their elements will be returned to the soil. Washed away by water and reach fish, plants, animals and other people. 

Am I that weird to think all these?

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There is an old joke about man showing up at the pearly gates and is greeted by St Peter.  The man was asked why he was so late he had died a week ago,  the man’s response was “ that’s ok I was in the ICU.”

I’ve been doing this for 40+ years.   We have palliative care now and one of my jobs is to bring that up to the team so we can discuss when it’s time for that.  In critical care everyone deserves the maximum effort and we tend to be pretty good at that, we aren’t so good at knowing when to stop.

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  • 1 month later...
On 3/30/2022 at 3:45 PM, Sharp-edge said:

I'm really glad it turned out well. I think we never give up, even when we know it's no use.

We have a guy these days that tried to commit suicide for the 4th time in his life. He won't make it (probably). That's sad. That guy was in pain (mentally) something bothered him very deeply and nobody managed to help him. I don't know who could have helped him, but nobody did. He was on antidepressants but I guess it didnt work.

And then, there is another guy that had a bike accident. He's in an induced comma, he's not in danger but if we try to wake him up he start to sweat endlessly (brain damage sign). I watch his mother during visits that she touches him and talk to him. You can feel her love. I mean it's obvious that she loves him, but feeling the love is intense. When I draw arterial blood (which is basically the only procedure I do to him as a training doctor) I just feel that one day as I bend his wrist he will grab my hand. But he doesn't.

I still haven't figured out the real purpose of a ICU. To extend the dying period of someone with no life expectancy? Or to be there for the very few that will survive? I am thinking of all the euthanasia thing. I would never be comfortable, if medical euthanasia was a thing in my country, to administer such a substance. On the other hand I think that "we torture" dying patients by keeping them alive. Maybe I'll be more happy or thinking less in my next rotation. O

Is it true that medical doctors make the worst patients? I am friends with an MD she loves to tell everyone else what to do both in general and for medical issues, but when she needed physical therapy she would skip appointments without calling to cancel, and just stopped going completely.

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On 4/21/2022 at 4:54 PM, Oldercumslut said:

we aren’t so good at knowing when to stop.

That's for sure !!!  When my life-partner of 30 years was in his final days, fortunately he had me to run interference on his behalf.  We had talked any number of times about the issue of doing everything possible, as opposed to letting go, and codified all the legal directives decades earlier.  Yet, when it came down to it, I had to holler at some doctor who came running into his room when all the horns started honking, and first tell her to read the charts on the door.  She paid not one instant's-worth of attention, so I hollered at her - in her face - to read what's in the charts hanging on the door.  This doctor froze momentarily, jerked her head towards the door, and one of her little minions ran over there and got the clipboard holding all the documentation.  All she said was "he will be passing shortly - these are your last moments together" - turned on her heel and stalked out. 

If I hadn't been there (sleeping in a lazy-boy in the middle of the night), he would have been forced to linger even longer.  As far as I'm concerned, they can shove their Hippocratic Oath waaaaay up their asses.  

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On 6/16/2022 at 8:10 PM, TotalTop said:

Is it true that medical doctors make the worst patients? I am friends with an MD she loves to tell everyone else what to do both in general and for medical issues, but when she needed physical therapy she would skip appointments without calling to cancel, and just stopped going completely.

That's a good question. Typically you start with hey I'm also an MD. This is a game changer because your doctor feels even more responsible. It's like "oh my  have to get the right diagnosis because not only will a patient will have issues because of me but he'll also start talking about me"..And yeah some can be really annoying but still it depends.

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