So, two years ago, when I left my OB program, I remember having this conversation with this guy I was soon to fall madly in love with (which turned out to be a terrible mistake - when isn't it? - but nevertheless) about what the hell to do with the rest of my life. And we went back and forth about finding a new residency and staying in gynecology and blahdy blah blah blah. And so I made the memorable comment, "I don't mind having to repeat my intern year. I mean, the intern shit, I can handle. Being an intern? That I can do."
You know what? I do sort of mind. I'm tired.
Today was long. We had a family meeting with the sons of a patient of mine who had something close to a catastrophic stroke, who's doing really poorly, and who, incidentally, I've taken a lot of flack on for doing things that were very reasonable (like calling the hospice people to see if she was eligible after my attending said, "Let's get hospice involved." And then this morning everyone was all, what?! You called HOSPICE?! I...um...yeah. Remember when you told me to?). It was heartbreaking. She was, by all reports, a vibrant and wonderful woman. She, now, can't eat, can't move half her body, can't stay awake, can't really communicate. And her son -when we were discussing whether or not to put in a feeding tube - says, "You know, as long as she can swallow" (which she currently can't) "that's fine. I mean, I don't care if someone has to feed her, or, you know, if she doesn't know what day or month it is, whatever."
I wanted to cry. I have a feeling that would matter to her.
Talk to your families, folks. Be explicit in your advance directives. Tell the people you love how you would want to be treated if you can't make those decisions. Talk to your family about what they want. It sucks to think about these things, and you don't ever want to think they'll happen to you or to anyone you love, but, it does. And you'll be glad you had those conversations in a calm, rational moment when things aren't so calm and no one is feeling very rational.
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1 comment:
it makes me crazy when people won't talk about it before it happens, like talking about it will make it happen.
Being an intern must be like childbirth, you forget how bad the pain really was. I can't believe you are willing to go through it again!!!!!!
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