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How Doctors Think about EOL Decisions for Themselves

Posted 7/7/2015

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  Clearly, you can't have it both ways. Or have your cake and eat it, too. I can't be in this gorgeous spot, looking at the tides come and go, listening to loons,  watching a virtual Wildlife Channel outside my windows AND have decent internet service. Sometimes it does work better than others, but this is, again, not one of those times. I know is is slightly weather dependent as this is a satellite system, and maybe it is influenced by how many others are trying to get on at the same, too. But it is frustrating and limits my willingness to write more than necessary; perhaps that is just as well for any readers, but I enjoy the chance to talk more with you all.

  Given those realities, this will be a shorter-than-desirable introduction to a terrific NPR piece about how doctors make EOL (end of life) decisions for themselves. This is similar to asking your doctor the famous question: What would you suggest that your wife/daughter/son do? It is somewhat harder to ask that question when the topic is DNR/DNI decisions or pondering a feeding tube or even thinking about hospice care. The gist of this article is that doctors are likely to die at home, if possible, and to make choices that result in more comfort care/less aggressive care at the end. There are surely exceptions. Two beloved physician friends, who had always counseled their patients to move towards palliative care and reject treatments that were not likely to be beneficial and were very likely to results in side effects, made exactly the opposite choices for themselves and died what seemed to be long and painful deaths in the hospital. We never know what we will decide in the moment, but it does help to think about in advance AND to discuss. these questions with our families.

  Here is the start and a link:

Knowing How Doctors Die Can Change End-Of-Life Discussions

Dr. Kendra Fleagle Gorlitsky recalls the anguish she felt performing CPR on elderly, terminally ill patients.

It looks nothing like what we see on TV. In real life, ribs often break and few survive the ordeal.

"I felt like I was beating up people at the end of their life," she says. "I would be doing the CPR with tears coming down sometimes, and saying, 'I'm sorry, I'm sorry, goodbye.' Because I knew that it very likely not going to be successful. It just seemed a terrible way to end someone's life."

Gorlitsky now teaches medicine at the University of Southern California and says these early clinical experiences have stayed with her.

Gorlitsky wants something different for herself and for her loved ones. And most other doctors do too: A Stanford University study shows almost 90 percent of doctors would forgo resuscitation and aggressive treatment if facing a terminal illness.

It was about 10 years ago, after a colleague had died swiftly and peacefully, that Dr. Ken Murray first noticed doctors die differently than the rest of us.

"He had died at home, and it occurred to me that I couldn't remember any of our colleagues who had actually died in the hospital," Murray says. "That struck me as quite odd, because I know that most people do die in hospitals."


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