Tuesday, October 20, 2009

On End of life care

Agar aap ko yaad ho to main ne is blog pe Shamsha aur Salim (here) ka zikar kiya tha. Kuch dinoN pehle mujeh ittlah mili ke un ki walida Karachi ke aik hospital main bohat bimar hai!

Main ne unhe phone kiya to Shamsha se baat hui. Baat bohat choti si hai magar bohat aham hai -aur shayed hum sab ko sikhati hai ke apne 'loved ones' ke aakhri ayyam main hame kiya sochna chahiye.

Jub Shamsha ne phone pe mujhe saari tafseel batai to main na khaha: "Dekho tumhari walida ke bachne ki umeed to bohat kum hai. Ye batao tum kiya chahti ho?....I mean do you want to be very aggressive till doctors do CPR, cardiac shock and code till technically pronounce dead or let her go peacefully if there is no reasonable hope. Un ki further treatment - is baat pe depend kerti hai ke - tum kiya chahti ho?"

Shamsha ne jawab diya : "Hum to bas unke liye aasani chahte hain!"

"Than remove ventilator and let her be pain free with morphine". I replied.

Bieng a physician, my impression is that - many times family members treat themselves and put their 'loved ones' through painful medical interventions which unnecessary just prolong their agony!

Magar ye sochne ki salaihiyat pane ke liye ke "Hum to bas unke liye aasani chahte hain!" - khud andar se bohat mazboot hona parta hai.

Trust me - its not easy!!

2 comments:

bsc said...

No doubt this is the toughest decision one has to make in his/her life but many physicians even are not totally aware of it and without looking at the human side of it make statements that are seen by people to be most unlike "Marcus Welby MD".
The help you provided also calls for courage compassion, sympathy humane-ness etc. It is like telling a patient about his/her poor prognosis. To my mind this is the most difficult part (and of course the most important) of being a physician.

mystic said...

I never watched "marcus Welby"....

When I was in training, I never understood its importance whenever attendings spoke of it but now it remains an integral part of my work...