Friday, April 27, 2012

Overcoming the Inevitable in Medicine: Doctors Simply Doing Their Best Under the Circumstances





There is the story of the two campers whose tent is about to be invaded by a hungry bear. Despite both knowing that a bear can outrun a human, when one camper noted that the other was putting on his running shoes and tightening the shoe laces, the camper asked the other "why are you doing that?" The other camper responded "I don't have to outrun the bear, I just have to outrun you!"

I think there are a lot of times in medicine when doctors are faced with the task of simply doing their best under the circumstances.  It is not that they are necessarily wholly incompetent, it is just that diseases, not the doctors, can have a way of controlling the outcome of the illness.  Physicians faced with such diseases in their patients such as cancers and other illnesses may rarely want to give up. They may decide to continue specific treatments to rid the disease, denying the obvious that the disease is overtaking the treatment.  Sometimes the patient or families encourage the physician in this regard. This is not at all an uncommon scenario presented to hospital ethics committees for consultation. 

There should be a time, however, when the doctor realizes and accepts the inevitable and begins approaches which are the best treatment and benefit for the patient under the circumstances. This may involve energetic palliative care, care to relieve suffering but treatment that no longer attempts to cure.  One cannot always think that doctors can outrun the inevitable but, like the camper, must find alternate ways to accomplish the best under the circumstances.   Any objection from my visitors?  ..Maurice.

Graphic: Hungry Bear from KRQE.com via Google Images.