God forbid I should be in a coma

...but if I were I'd want this doctor treating me. Come to think of it, I'd want him treating me no matter what state of mind I was in.

Comments

[Russ]

I don't agree with Dr. Bradley (Kill as Few Patients as Possible) on too many things (including the Schiavo case), but I still find most of what he has to say to be thoughtful none-the-less.

I've blogged (this being just one example) about the Schiavo thing plenty of times (and have commented on Dr. Bradley's blog), and each time, I can't help but go back to my own personal experiences with my grandfather, who ended up in a persistent vegetative state following a series of strokes. In that instance, we kept the feeding tubes in all the way up until "natural" death. We saw all the movements, twitches, reactions, noises, etc. as some form of attempt to communicate. In retrospect, I've concluded that this was all wishful thinking, and that there simply was no cognitive intelligent function at work, and that these movements and noises were about as primal and had nothing to do with any kind of self awareness at all.

For a good analysis from a different perspective, check out Health Law Blog and scroll down (sorry, permalink doesn't work) to the article entitled: The Schiavo case: legal process run amok.

Russ
Legal Memo-Random

[Ernie]

In case anybody miscontrues my point, I don't want to be kept alive when I'm in the condition that Ms. Schiavo is in. My relatives know I want the plug to be pulled. My point is that more doctors should care for the patients with the depth of feeling that Dr. Bradley exhibits. If he treats his comatose patients the way he described then can you imagine how well he treats his non-comatose patients?

[Craig]

Ernie: Thank you for the kind words. Of course I'm more of a butthole to the patients who talk back. :-)

Russ (and Ernie, and anyone else): I think the Schiavo case is a very unique one in that there are a lot of extenuating circumstances with her husband. I mean, for goodness sake, how can you consider yourself to be someone's spouse when you've moved on to the point of having children with your new girlfriend. Also, after the first couple of years, he has refused rehab for her. Further, Terri's condition is not progressive, not worsening. Finally, the link in the post on my site to the audio from a former 'permanent vegetative state' patient is very compelling.

But don't get me wrong. As I blogged before the law in Fla. passed, I have significant doubts as to whether such legislative action was appropriate. I don't want to worry about legal consequences or whether the decision could be overturned when I'm discussing end of life/resuscitation efforts with the family of a dying patient. This is a tough enough decision without worrying about whether you're breaking the law.

I have had two great "fears" in these issues. One is that through the alleged miracle of modern technology we might literally tether a soul to a body when it really needs to leave. This sounds goofy, perhaps, but what if that is the case? My other fear, which comes up much less often, is that the patient who for all intents and purposes appears to be gone, may in fact be hearing every word we say as we discuss whether or not to withdraw life support measures.

In any event, I hope that in my efforts to affirm the sacredness of life, I have not given the impression that I am in favor of uncorking every conceivable mechanical, chemical and invasive intervention in every single case. Life does end, and sometimes it's best to shuck our own feelings or pride and let that happen. Certainly, had Terri Schiavo clearly expressed her feelings beforehand, this issue would be viewed very differently.