March 04, 2016 Nayab Alam
Medics, Mortality, and Morality
In today’s day and age, modern medical practices and treatments have almost single-handedly led to an increase of life expectancy by about 40 years. In fact, many call modern medicine the inventor of old age. Doctors, nurses, and other health care professionals work tirelessly to treat, prevent, and cure their patients and their lives. Due to these noble efforts, our society as a whole, on a universal scale, regards these public servants with the highest esteem, especially doctors, who are considered to be the heart and backbone of health care. The reverence we feel for these individuals may be the reason why so many students, myself included, have decided to take the pre-med course of education, and why we strive so hard to shape ourselves into the physicians we universally admire. However, in our struggle to achieve our dreams and ambitions, I feel as though we may have forgotten to address a fundamental truth that physicians must learn to accept: death.
Death is an undeniable facet in the medical world. Although it casts a dark shadow on the face of an otherwise miraculous field of work, it is crucial that we, the students who are striving to become health care professionals, actively acknowledge how physicians deal with the loss of lives and the effects they have on their patients’ loved ones. The question then arises: is the narrative of death in the medical field long over-due for a change? Before doctors actually become doctors, before they have seen the loss that comes with the territory of their profession, they too deal with the tragedy of death as most frustration and grief. However, once they have had to deal extensively with this tumultuous aspect of their careers, they become almost stoic in the face of death. But who can blame them? In order to continue doing their jobs and helping people, they must put their emotions behind them. Eventually, these individuals become so used to the transience of life that they are essentially immune to it. It is almost as if each consecutive death is a vaccine, but this extreme coping may in fact be quite detrimental, to not only the patients’ loved ones, but also to the physician.
The fundamental issue here is that most health care professionals receive little to no training regarding this matter. As students they spend years studying, absorbing textbook material, perfecting techniques in skills labs, doing every comprehensible thing that would arm them with the tools to prolong life and evade death. Unfortunately, amongst the pages and pages of information and the hours upon hours of lectures and practicums, not much can be found regarding morality. The frailty of human life and the complexity of the human condition after a tragedy such as death are not significant components of study. And, as Atul Gawande, a renowned surgeon and author explains, “We paid our medical tuition to learn about the inner process of the body, the intricate mechanisms of its pathologies, and the vast trove of discoveries and technologies that have accumulated to stop them. We didn’t imagine we needed to think about much else” (Gawande, 5). As students, there is not enough training dedicated to teaching how to effectively and compassionately communicate with bereaved family and friends.
This becomes especially damaging when dealing with the patients’ family and their loved ones. While volunteering in a hospital’s ER, I often made rounds in the waiting room, finding patients’ family members and giving them as many details as I was allowed. Sometimes, I would sit with the younger individuals, and simply provide some company to those who were worried and alone. I remember one girl, who was about 13, waiting to be informed about her mother’s condition after a car crash. This girl herself had been already treated for the minor injuries she attained from the wreck, and her brother had been taken by a close family friend earlier in the day. As I was sitting with her, she asked me how her mother was doing. Regardless of the fact that I truly was not aware of her mother’s condition, I was not allowed to say anything, so I just said the doctors were working as hard as they could. She looked at me with swollen eyes and told me about how the EMT that was with her in the ambulance had told her, with absolutely no hesitation, that her mother died on the scene and then proceeded to essentially torment her for menial information such as her address and social security number. It astounded me, that a professional would pay no heed to this child’s feelings and subsequently destroy any semblance of hope remaining.
Unfortunately, these experiences are replicated almost universally, signifying that perhaps some sort of preemptive action should be taken in order to intrinsically change how health-care professionals should deal with the sensitive issue of mortality. And although it makes sense that doctors must harden themselves so that they can continue to live their personal lives, which in most cases involve supporting their own families, while simultaneously continuing to effectively help others, is it morally acceptable? As someone who is interested in entering the medical profession, I realize how important it is that I develop the nerves of steel that doctors are famous for. I realize that a great deal of strength is required in these situations, and one can never let their emotions overrule them. But that being said, how willing am I, how willing are we, to completely lose our ability to feel? Yes, pragmatism is fundamental, but that does not mean that as doctors, or EMT’s, or nurses, that we should allow death to beat us until we are numb to it, rendering us more as robots and less as humans.
How willing are we to lose our human essence? Yes, the amount of good that we would do is insurmountable, but who’s to say we can not be mournful and acceptably emotional when dealing with the end of human life?