Sometimes it's harder to deal with a dying patient than it is to deal with one who needs to be treated aggressively. Of course, the latter will require you to be on your toes and the whole process is just extremely intensive. Hence a lot of times, it seems easier to be dealing with the dying one - just write down BSC( Best supportive care) and adjust morphine and walk off - or at least that's what it looks like on the surface.
But after working for 2 months in the department, I've come to realise that treating a dying patient is not just about morphine alone. It's about looking at him as an individual, it's abt looking at the family's needs, expectations and so on.
The hardest questions to handle are ' you are not putting on the drip for him because he is dying right? you are making him dehydrated and it's like murdering him' How do you answer a relative who poses this qn? Even though you try to give a mini 'S.O.' lecture on how what actually matters is the feeling of hunger and thirst and that the drip is not gg to make much of a difference, or rather do him more harm than good, - not everyone can understand that. At the end of the day it boils down to the family's expectations and understanding of the patient's condition, which on the other hand also implies how much of effort we have put in as doctors to educate the families. It's certainly not the eaiset thing to do - not something you can spend 2 minutes in front of the family n walk off but it is extremely important.
A lot of people think that the hardest part of the job is dealing with the actual death of a person. I disagree. The harder part is dealing with the dying process and dealing with the people involved in the process. That's what is challenging. And that is also the satisfying bit - when you know that you have attempted to alleviate as much suffering as possible for this person in his last days and that he has left this world in peace - it is extremely satisfying - it makes you as the physician feel at peace as well. Especially when the family comes to thank you for making their loved one leave confortably - It is absolutely worth that extra time spent for that patient.
Friday, December 25, 2009
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