Playing Doctor

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Thursday, September 1

Immortality, risk : benefit


We all enjoy things that carry a potential price tag on our health. We justify these enjoyments by laughing and (mis)quoting Ecclesiastes ‘eat, drink, and be merry, for tomorrow we die.’ And yet, we can be so critical of the dangerous enjoyments of others that we do not share.

The promiscuous judge smokers. Smokers judge overeaters. Overeaters judge motorcyclists. All have their entailed risks, all have their entailed pleasures. All the pleasures outweigh the perceived risks for those that partake in them.

There are those whose pleasure results directly from the risk itself: skydivers, bungee-jumpers, and shark divers, for example. Though I find such frivolous risk-taking a symptom of a pedestrian life, I’ll admit that when I slide my fingers between the ribs of a patient with hepatitis C and HIV, insert a chest tube, and withdraw my hand intact, the thrill is nearly palpable. The sense of invulnerability you feel from making it unscathed from such a danger is rather pleasurable. ‘Look at what I can do,’ my id screams at my ego, ‘pussy!’


When patients come to see me, they will sometmes confess that they are able to eat a low-salt diet, except for barbeque; that they are good with their diabetic diet, except for grapes; that they take their medications, except the one that makes them feel bloated.

It’s then that we have a conversation.

The goal for my patients is not ascetic immortality. All of my patients—and myself—will eventually die. It’s my goal to help them live a healthy life for as long as possible, minimize risks that do not enrich their lives, and encourage things that will keep them active and interested in life. If their lives are cut short by their enjoyment of life, so be it. As long as they understand the risks, they are free to live life on their terms. That’s my goal as their physician.

By my recollection, the only two people who escaped death were Elijah and Jacob, and medicine didn’t have any role in that. We can offer no salvation. The best we can offer is a stall—a brief reprieve to enjoy life—before returning to the ground.


Blogger _ Art Epp writes:

I do wish that you never loose sight of this goal throughout your practice.
These are things I hope all physicians
try to achieve.

..Art ..a sarcoma survivor & kid.transplant patient


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