Long tail
Tickets
A very interesting article in this week’s New Yorker by Atul Gawande about doctors and dying: ‘People have concerns besides simply prolonging their lives. Surveys of patients with terminal illness find that their top priorities include, in addition to avoiding suffering, being with family, having the touch of others, being mentally aware, and not becoming a burden to others. Our system of technological medical care has utterly failed to meet these needs, and the cost of this failure is measured in far more than dollars. The hard question we face, then, is not how we can afford this system’s expense. It is how we can build a health-care system that will actually help dying patients achieve what’s most important to them at the end of their lives.’
(…)
‘I think of Gould and his essay every time I have a patient with a terminal illness. There is almost always a long tail of possibility, however thin. What’s wrong with looking for it? Nothing, it seems to me, unless it means we have failed to prepare for the outcome that’s vastly more probable. The trouble is that we’ve built our medical system and culture around the long tail. We’ve created a multitrillion-dollar edifice for dispensing the medical equivalent of lottery tickets—and have only the rudiments of a system to prepare patients for the near-certainty that those tickets will not win. Hope is not a plan, but hope is our plan.’
It’s good to realize as a patient (and as a doctor probably) that what you want to believe is science is just hope.
And I’m skeptical of hope, as my more regular readers might know.
To quote Tadeusz Borowski: ‘Never before in the history of mankind has hope been stronger than man, but never also has it done so much harm as it has in this war, in this concentration camp. We were never taught how to give up hope, and this is why today we perish in gas chambers.’
Science
The question may be to what extend science can be a-moral. Personally i believe it's not really possible for science to be a-moral which will make it nessecary to make moral choices also within that field. Better then to keep up the apperances of a-morality.Icecream
Milan:What do you think is the morality underlying Newton's laws of motion?
Mr. Grunberg:
Do you feel you battle with the errors in our current medical system by smuggling icecream cones?
I know, it's a sensitive subject.
A thought came to me that even the doctor has no idea what his statement really meant, what death really means to the person involved. And so does none of us.
Maybe we rather be dead?
Most doctors are.
Am I lucky both my parents are PHD, but now I want to marry Carecia.
My mother : she is old. 79, but drives a care like a young american teen. Well, she is a Dammned Plantagenet-gall!
Three out-doors cats in the room. Arnold Zwarzzennneger, now my mother wants to go and went, she to.. gave up about everything for her child , if only I knew .
She, my mother sung her songs in my littlle decomposed sheep- tavern.
But , know she's sweet ,, yes, I will say a our father in heavens too,
Still she is lurking in a corner,
Milan
Nature is by definition amoral. The study of nature, science, therefore doesn't speak in moral- immoral terms, otherwise they leave the field of what is called science.Although once in a dream I understood Russian, and in a ‘so called delirium’ I have seen a nice parcel of running leprechauns, I am still not able to translate in modern Hungarian.
I am sure one day you will be able to, and so much more.
Mieke
What is nature and what not in the subject article?This is, perhaps subconsciously, why you told the taxi driver you were a cardiologist.
They make the most money.
