Producer’s note: Someone on Quora asked: If you’re a medical practitioner, what revelations have you had about health and mortality since you’ve been working in this field? Here is one of the best answers that’s been pulled from the thread.
- Nobody is an island, usually the success in treating severely ill patients is the success of a team including all kinds of people, not just one person, although one person must take the lead, and that being one of the docs.
- In spite of all the advances we’ve made in these last 30 years, mortality in the best Intensive Care Units is still around 20%, not because our therapies fail, but because we get sicker patients e.g. older patients in worse conditions than before are now undergoing major surgery, so are a lot sicker afterwards when they need to be helped to recover from this illness.
- Since as a doc you have to deal with lots of people all the time, soft skills are so very important, most patients can only judge their doc by what they experience of these soft skill. A kind, attentive, friendly, smiling doc is more often seen as a good doc in spite of some or even sometimes serious failings technically. Most litigation procedures start with communication problems between a patient and the doc.
- In many conditions we aren’t able to magically diagnose, treat and cure you just like that, in fact most non surgical care involves long term care for chronic treatable but incurable conditions like diabetes. People’s expectations don’t match our true live capabilities.
- Many people think every CPR must be successful, wrongly thinking so because what unrealistic television shows show us. At present in real life only about 2 to 6% of those who had had an unwitnessed cardiac arrest will leave the hospital more or less neurologically intact. The others are either dead (the majority of them) or severely neurologically damaged. That’s why some knowledgeable (e.g. rehab) docs don’t ever want to be resuscitated especially by inexperienced lay people who because of inexperience wait too long before starting CPR (>3 minutes) so the brain is already “fried” by the time they start CPR because to most of us survival without much brain function but not dying is the worse that can happen to us.
- Exposing incurable people in their dying days to all kinds of last ditch ineffective, taxing, useless and expensive desperate treatments is inhumane, since it does the patient no good, just prolonging the agony of dying, and should be avoided. Unfortunately this kind of advice often as seen as the team’s unwillingness to do their best for the patient, especially family members with less than optimal relationships before feeling so guilty so they would feel even more guilty should they chose the optimal hospice care option being optimal care and attention, meds against pain, against shortness of breath, against anxiety, and no useless meds often having serious side effects since they wouldn’t do any good anymore in one dying, all this if possible in a low tech more home like (or in some cases even hospice care at home) environment. People forget that we all are mortal, and no amount of money can stave off death.