When Doctors Face Death
By PAULA SPANA telling essay about the way doctors choose to die, as opposed to the way most of their patients will, appeared on a Web site called Zocalo Public Square last month and has been ricocheting around the Internet ever since — to its author’s astonishment.
He reads three to four books a week (one recent week: an anthology of creative nonfiction, a military adventure, a Bob Woodward investigation and an obscure tome on communications). He attends 10 to 15 lectures each month. He’s a certified sailing instructor and a volunteer forester who, the day we finally spoke, had just clambered down from an 80-foot Ponderosa pine.
“How Doctors Die” was the third of three posts Dr. Murray had agreed to write for Zocalo. His first received one comment and the second two – all from people he knew. When I last checked, the third had drawn nearly 400 and has by now surely reached hundreds of thousands of readers. “I am in shock,” said Dr. Murray, who’s 59. “This was a nerve that was ready to be hit.”
Dr. Murray contends in his post that doctors know too much about the futility of aggressive end-of-life treatment to subject themselves to it. His argument is anecdotal, based on people he has known but lacking statistical underpinnings. “It’s a fair criticism,” he said.
But recently an alert reader e-mailed him a study, published in 2008 in The Archives of Internal Medicine, of more than 800 physicians who graduated from Johns Hopkins University between 1948 and 1964. Most had reached their late 60s and 70s, so questions about end-of-life treatment were not purely hypothetical.
Asked what treatment they would accept if they’d suffered irreversible brain damage that left them unable to speak or recognize people but was not terminal, the doctors overwhelmingly said they’d decline CPR, feeding tubes and a host of other common interventions. “So there is actual evidence about this,” Dr. Murray said, pleased.
He’s also pleased that the subject of how we die, doctors or otherwise, has such resonance. “Twenty or 30 years ago, it was not socially acceptable to talk about this stuff, so these discussions didn’t happen,” he said. “Now we are having them, even though we’re all uncomfortable with them because there’s so much emotion tied up with this.”
“But it has to happen,” he added. “We’re finding our way.”
We talk about this stuff all the time, of course, but rarely so eloquently. Read “How Doctors Die.” I’m sure Dr. Murray will be interested to hear what you think.
I first saw the essay, “How Doctors Die,” on Twitter. Others came across it via Andrew Sullivan’s blog on The Daily Beast. It’s popped up on news sites, religious and medical sites, and probably thousands of individual blogs.
So I’m a bit late to this party, but with an excuse. I wanted to talk to Dr. Ken Murray, the retired family practitioner in Los Angeles who wrote the essay, before I posted the link. That wasn’t so easy to do, in part because of Dr. Murray’s extremely energetic definition of “retirement.” Since closing his practice four years ago — with the way medicine has changed, he told me, “each day it was a little less fun” — he hasn’t been sitting around waiting for reporters to call.He reads three to four books a week (one recent week: an anthology of creative nonfiction, a military adventure, a Bob Woodward investigation and an obscure tome on communications). He attends 10 to 15 lectures each month. He’s a certified sailing instructor and a volunteer forester who, the day we finally spoke, had just clambered down from an 80-foot Ponderosa pine.
“How Doctors Die” was the third of three posts Dr. Murray had agreed to write for Zocalo. His first received one comment and the second two – all from people he knew. When I last checked, the third had drawn nearly 400 and has by now surely reached hundreds of thousands of readers. “I am in shock,” said Dr. Murray, who’s 59. “This was a nerve that was ready to be hit.”
Dr. Murray contends in his post that doctors know too much about the futility of aggressive end-of-life treatment to subject themselves to it. His argument is anecdotal, based on people he has known but lacking statistical underpinnings. “It’s a fair criticism,” he said.
But recently an alert reader e-mailed him a study, published in 2008 in The Archives of Internal Medicine, of more than 800 physicians who graduated from Johns Hopkins University between 1948 and 1964. Most had reached their late 60s and 70s, so questions about end-of-life treatment were not purely hypothetical.
Asked what treatment they would accept if they’d suffered irreversible brain damage that left them unable to speak or recognize people but was not terminal, the doctors overwhelmingly said they’d decline CPR, feeding tubes and a host of other common interventions. “So there is actual evidence about this,” Dr. Murray said, pleased.
He’s also pleased that the subject of how we die, doctors or otherwise, has such resonance. “Twenty or 30 years ago, it was not socially acceptable to talk about this stuff, so these discussions didn’t happen,” he said. “Now we are having them, even though we’re all uncomfortable with them because there’s so much emotion tied up with this.”
“But it has to happen,” he added. “We’re finding our way.”
We talk about this stuff all the time, of course, but rarely so eloquently. Read “How Doctors Die.” I’m sure Dr. Murray will be interested to hear what you think.
Paula Span is the author of “When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions.”
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