INDUBITABLY

ziyadmd:

It’s an old joke: a long line of people waits at the Pearly Gates as St. Peter slowly checks them in, taking an eternity. Little guy in a white coat shows up, carrying a leather bag, stethoscope around his neck. St. Peter waves him through. “What the hell was that?” someone asks. “Why does that doctor get cuts?” “Oh, that wasn’t a doctor,” Pete says. “It was God. He just likes to play doctor once in a while.”

But it’s no joke. Whereas I don’t buy the “playing God” aphorism, I’ve had to make life-and-death decisions on occasion, and I don’t like it. I mean “life and death” literally: this person lives. That one dies. Saving a life is nice, and part of the job; failing to save one is horrible, yet inevitable. But deciding in advance — looking at a situation and concluding it best to let things go, or choosing to render help when the outcome might be regrettable — is a responsibility beyond understanding. Maybe it also comes with the territory, but who has the roadmap?

Bowel infarction is a good example. Dead bowel happens for a lot of reasons. Untreated, of course, it’s fatal. In operating, one may find — depending on the cause and the anatomy — a small segment of intestine the removal of which is not only life-saving but free of side effects; or you might find essentially the entire gastrointestinal tract dead and black. Removal in that case is possible, too, leaving the person entirely dependent upon permanent intravenous feedings. Or there might be enough small and large intestine remaining to handle oral intake with or without intractable diarrhea, with or without the need for complicated supplemental nutritional support.

And there you are, in the operating room at three in the morning, looking into a belly. No crystal ball, no outcome-prediction software; no moral counseling or ethics committee with two-cents worth of advice. What resources do you marshall; how do you decide whether to close up and deliver the bad news to the family, or to go ahead? Can you make a decision without interjecting your own moral values? Should you? Surely it’s conceivable that two people might make different decisions; ergo, it’s subjective. Who, then, has the right? Rarely, you may know enough about the patient to have an idea of what he/she would want. But how can you apply that when you’re not sure what kind of life will result from going ahead? Wrongful death? Wrongful life?

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(Source: ziyadnazem)

Mar 31
God of the Operating Room

"A man should look for what is, and not for what he thinks should be."

- Albert Einstein (via artoflivingslowly)

Mar 31
jtotheizzoe:

Know the Warning Signs of Science
(ᔥLife Technologies)
Mar 31

jtotheizzoe:

Know the Warning Signs of Science

(Life Technologies)

theweekmagazine:


“The experience wasn’t simply about the easy pleasure of undeserved expertise. For me, it was a near-spiritual experience. When a nice neuroscientist named Michael Weisend put the electrodes on me, what defined the experience was not feeling smarter or learning faster: The thing that made the earth drop out from under my feet was that for the first time in my life, everything in my head finally shut up.”

Sally Adee volunteered for electrical brain stimulation. Here’s what happened
Mar 31

theweekmagazine:

The experience wasn’t simply about the easy pleasure of undeserved expertise. For me, it was a near-spiritual experience. When a nice neuroscientist named Michael Weisend put the electrodes on me, what defined the experience was not feeling smarter or learning faster: The thing that made the earth drop out from under my feet was that for the first time in my life, everything in my head finally shut up.”

Sally Adee volunteered for electrical brain stimulation. Here’s what happened

rogerwilkerson:

Shop Northgate!
Mar 29

rogerwilkerson:

Shop Northgate!

Mar 17