While I wrote this article in 2011, it is still very relevant today. Last night at my friend’s Christmas Eve celebration, one of his guests and I actually had a conversation about this very topic. When I got home, I dug this out of my archive.
A lot has changed since 2011. The most important thing is that now I am dealing with a progressive neurological disorder that is slowly stealing my life away. My own thoughts change on a daily basis, but one thing is for sure; I do not want the government/Medicare to determine how long I live and how I die. Those decisions belong to my family and me.
The second thing that I know for sure is that life without quality is not really life. Each of us has to decide what quality of life means and, perhaps, when our lives should end.
July 20, 2011
Sometimes you just don’t want to be right. Over the past many years, I have seen an alarming pattern arise in my profession. Many of my patients have heard me talk about “Soylent Green”, an old Charleton Heston movie. I have even written about it on this blog. The premise of the movie seems absurd. Can you imagine the government of the United States providing for all the needs of its people including healthcare, food, clothing, and even death (Food Stamps, Medicaid, Medicare, Social Security)?
David Brooks’ opinion piece in the New York Times on July the 15th (http://www.nytimes.com/2011/07/15/opinion/15brooks.html?_r=1) makes my fear of a “Soylent Green” society frightenly real. While I recommend you read the entire piece, for the purpose of this blog, I want to highlight the following:
Mr. Brooks writes, “This fiscal crisis is about many things, but one of them is our inability to face death _ our willingness to spend our nation into bankruptcy to extend life for a few more sickly months.” He quotes S. Jay Olshansky as saying, “our main achievement today consist of devising ways to marginally extend the lives of the very sick.” He then closes his piece with “we think the budget mess is a squabble between partisans in Washington. But in large measure it’s about our inability to face death and our willingness as a nation to spend whatever it takes to push it just slightly over the horizon.”
In “Soylent Green”, the citizens dutifully walked into the death chamber when it was their time. Mr. Brooks would be proud of how those brave souls faced their demise for the good of society. Rather than “marginally” live another month or two, costing society a fortune and threatening a budgetary crisis, the citizens of “Soylent Green” did as prescribed, they follow the “protocol” created to save society (prescribed “outcome” equals death).
My question for Mr. Brooks is who defines what “marginally extends the lives of the very sick” is? Who decides who shall live and who shall die? I can’t! Not long ago, I met a “very sick” patient in the emergency room. He was critically ill having had a catastrophic event. He was comatose with signs of profound damage. The neurologist told the family he was “brain dead”. While Mr. Brooks believes that medical science has made very little progress in extending life, my patient benefited from a remarkable new invention, the “Artic Sun Hypothermic Unit”, and fully recovered. I spoke to him this a.m. He was at work! Editor’s Note: He’s still alive today, 15/26/19.
The procedure and hospitalization cost in excess of $300,000. Saving this one life cost a fortune! In Mr. Brooks’ world, should we have forgone this patient’s treatment and helped his family “face death”? Are we “spending our nation into bankruptcy” by working hard to save lives? Maybe so. But who are we if we don’t care for our ill? What do we become when we arbitrarily decide what a life’s value is?
Mr. Brooks obviously doesn’t practice medicine. If he did, he would know that an individual life is worth everything to that person and his family. Mr. Brooks would know that patients survive against all odds and recover to enjoy meaningful lives. He would know that statistics lie! A patient with a life ending cancer is told he has three months to live without treatment and 6 months with treatment. Despite the tremendous expense both financially and physically, he accepts treatment. Seven years later he is thriving!
Respectfully, Mr. Brooks doesn’t know what he is talking about. The problem is the policy makers aren’t doctors. The policy makers are Mr. Brooks’ cronies. “Soylent Green”, here we come!