The Battle

We live in a world of percentages: % complete, % remaining, % survival, winning percentage and so on…

Once we digest these numbers, confidence grows or it sinks. When these numbers pertain to life and death, choosing to battle is the default option against the odds. However, lines should be drawn when the odds of survival are really low. But, it’s a line crossed many times due to fear of the unknown.

The decision point should come from heartfelt discussions between families, patients and doctors. It’s a candid conversation which may not happen in a hyper-busy environment, so the treatment continues until the very end— at extraordinary cost to all parties involved.

Physician Atul Gawande highlights this dilemma which affects patients and doctors alike. End-of-life scenarios creep up unexpectedly and no one is prepared for these type of conversations. And the doctors might not care to ask. The bu$iness of medicine usually wants more.

Yet, the best decision might be to accept an inevitable outcome (as forecasted) and devote the remaining time with one’s family — peacefully, away from the hospital.

“All-out treatment , we tell the terminally ill, is a train you can get off at any time—just say when. But for most patients and their families this is asking too much. They remain riven by doubt and fear and desperation; some are deluded by a fantasy of what medical science can achieve. But our responsibility, in medicine, is to deal with human beings as they are. People die only once. They have no experience to draw upon. They need doctors and nurses who are willing to have the hard discussions and say what they have seen, who will help people prepare for what is to come—and to escape a warehoused oblivion that few really want.”

Atul Gawande

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