Anybody choose a specialty because they can't stand death?

[Silent Cool]

so how about it--was avoiding seeing death as much as possible a factor in anyone's decision?
😎

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[DropkickMurphy]

Nope, death doesn't bother me. Suffering does, but the "actual" death generally doesn't bother me.

 

[Sohalia]

so how about it--was avoiding seeing death as much as possible a factor in anyone's decision?
😎

This is an odd question. Are you even in medical school? I ask because in the US most people are at least 22 yrs old when they enter, and 24 or so when they start significant clinical work. This question just seems kind of immature. Being able to deal with death in a mature fashion is part of being a physician.

 

[penguins]

This is an odd question. Are you even in medical school? I ask because in the US most people are at least 22 yrs old when they enter, and 24 or so when they start significant clinical work. This question just seems kind of immature. Being able to deal with death in a mature fashion is part of being a physician.

Hey, let's take this question more seriously. I don't know what a better specialty would be... pathology maybe. You wouldn't be actively involved in death.
Acknowledging that you aren't comfortable with death is a lot better than pretending like you are and being insensitive to the family and the patient when the time comes.
Dealing with death is one of my favorite parts of the job (you guys know what I mean, no need for jokes here) and I have more respect for people that admit they aren't comforable with it than for those who fumble through it.
Maybe the OP, hasn't really experienced it yet. It might get easier for you, try to talk to someone about it and don't hesitate to ask advice from someone farther along in the process about your concerns. Sometimes someone you know and trust can help you out with this.
You aren't the first person to have this problem and it isn't unnatural or immature. Admiting you have a problem... is the first step.... 😉

 

[skypilot]

I have definitely heard of people choosing Obstetrics because they don't want to generally see people slowly decline and die. Of course there is the occasional infant death or OR death but it is a rare occurence. Same with Derm and Ortho.

 

[CANES2006]

Dealing with death doesn't really bother me. However, I don't particularly like chronically/critically ill patients. Thus, I'm going into OB/GYN where for the most part patients are relatively healthy (except in GYO) and I hardly ever have to go to the SICU/MICU.

 

[Silent Cool]

I have definitely heard of people choosing Obstetrics because they don't want to generally see people slowly decline and die. Of course there is the occasional infant death or OR death but it is a rare occurence. Same with Derm and Ortho.

yah, that's what i was thinking. i mean, to a certain extent every physician deals with it, but varius fields aren't much involved in the treatment of what's really causing the death, fields like derm, optho, ortho, ob. i guess in that sense, these are some of the happier fields, whereas a field like oncology, man, you've gotta have a stomach to deal with dying cancer patietns all the time. fields like gen surg and IM seem to deal directly with the dying patients a lot. it just seems that certain fields are largely (not totally) immune to it. i figured that might be part of why some people decided on them--they're happier 🙂

😎

 

[skypilot]

yah, that's what i was thinking. i mean, to a certain extent every physician deals with it, but varius fields aren't much involved in the treatment of what's really causing the death, fields like derm, optho, ortho, ob. i guess in that sense, these are some of the happier fields, whereas a field like oncology, man, you've gotta have a stomach to deal with dying cancer patietns all the time. fields like gen surg and IM seem to deal directly with the dying patients a lot. it just seems that certain fields are largely (not totally) immune to it. i figured that might be part of why some people decided on them--they're happier:

Even in ER med you don't see the gradual decline. Just the sudden ones. I guess it depends on what aspect you don't like. Dealing with chronic illness or dealing with life threatening emergency? I suppose "outpatient only" FP or IM would get you away from some but not all of these aspects as well. 🙂

 

[sepsis]

This is an odd question. Are you even in medical school? I ask because in the US most people are at least 22 yrs old when they enter, and 24 or so when they start significant clinical work. This question just seems kind of immature. Being able to deal with death in a mature fashion is part of being a physician.

It doesn't seem an immature question to me. I am 33, have completed almost 4 years of medical school and have not yet seen a person die. Quite frankly I don't know how I will handle it (I have an idea and a game plan) or how it will affect me.

To think about this question is important and a very natural question whether going into medicine or residency.

The mature person is one that questions many aspects of dying including whether they are able to handle it. It may surprise you to find out that some of your classmates don't want that aspect of medicine to be a part of their career.

just my 2c.

 

[PickyBicky]

It doesn't seem an immature question to me. I am 33, have completed almost 4 years of medical school and have not yet seen a person die. Quite frankly I don't know how I will handle it (I have an idea and a game plan) or how it will affect me.

To think about this question is important and a very natural question whether going into medicine or residency.

The mature person is one that questions many aspects of dying including whether they are able to handle it. It may surprise you to find out that some of your classmates don't want that aspect of medicine to be a part of their career.

just my 2c.

Wow, never seen someone die, and you're nearly done with medical school? Did you do trauma with surgery? An ICU month? An IM wards month? It's not a cut or a criticism, I'm just astonished that it has happened yet.

-PB

 

[robotsonic]

I don't mind being around death. I do mind watching patients who, in a humane world, would have died months ago if it weren't for the machines and the caregivers who insist on keeping them locked in a half-demented almost-vegetative state. Death is natural; a humiliating existence is not.

 

[DOtobe]

Wow, never seen someone die, and you're nearly done with medical school? Did you do trauma with surgery? An ICU month? An IM wards month? It's not a cut or a criticism, I'm just astonished that it has happened yet.

-PB

I didn't see anyone die until my next to last rotation in my fourth year, which was my ICU rotation. And that month it was like the Grim Reaper was coming through the ICU 🙁

I hate being called to pronounce a death - I still haven't found the right way to ask a grieving family if they want an autopsy. It seems heartless to me to ask right after the pt dies, but I guess it has to be done...

 

[fuzzyerin]

I have definitely heard of people choosing Obstetrics because they don't want to generally see people slowly decline and die. Of course there is the occasional infant death or OR death but it is a rare occurence. Same with Derm and Ortho.

That's what I say about ob too, until you have a bunch of people come in with missed abortions, miscarriages, or fetuses with lethal abnormalities and you realize you've had a more depressing day on L&D with more death than delivering babies. I definitely picked ob/gyn because I prefer the "healthy" patient, but we get our share (and sometimes, more than our share) of death.

And nothing sucks more than pronouncing a baby. So far, that's the only death I've had to pronounce, and it sucks.

 

[DarksideAllstar]

I don't know what a better specialty would be... pathology maybe. You wouldn't be actively involved in death.

Are you serious? 🙄 Pathologists perform the post mortem exams as requested by the clinical team. I would say that pathologists are probably more "actively" involved in death than most clinicians. Granted you can find pathologists in subspecialties (dermatopathology and hematopathology, for instance) that do not deal day to day with sutopsies. However, any pathologist who has trained in anatomic pathology has had around 50 "experiences with death".

Although I have a small sample size, I have yet to see a single clinician who has requested a post be present for even a small part of the gross examination.

 

[penguins]

Are you serious? 🙄 Pathologists perform the post mortem exams as requested by the clinical team. I would say that pathologists are probably more "actively" involved in death than most clinicians. Granted you can find pathologists in subspecialties (dermatopathology and hematopathology, for instance) that do not deal day to day with sutopsies. However, any pathologist who has trained in anatomic pathology has had around 50 "experiences with death".

Although I have a small sample size, I have yet to see a single clinician who has requested a post be present for even a small part of the gross examination.

oops, was thinking of those that looked at slides in lab. didn't think about the above.

 

[DropkickMurphy]

Actually I believe only anatomical and forensic pathologists do autopsies with any regularity....Both of the hematopaths I know have made the comment that the last time they did an autopsy was when they were in residency.

 

[DropkickMurphy]

That's what I say about ob too, until you have a bunch of people come in with missed abortions, miscarriages, or fetuses with lethal abnormalities and you realize you've had a more depressing day on L&D with more death than delivering babies. I definitely picked ob/gyn because I prefer the "healthy" patient, but we get our share (and sometimes, more than our share) of death.

And nothing sucks more than pronouncing a baby. So far, that's the only death I've had to pronounce, and it sucks.

Add that to the long list of reasons I don't want to do OB.

 

[Blade28]

Nope, not afraid.

 

[neilc]

Dealing with death doesn't really bother me. However, I don't particularly like chronically/critically ill patients. Thus, I'm going into OB/GYN where for the most part patients are relatively healthy (except in GYO) and I hardly ever have to go to the SICU/MICU.

amen. the relative lack of chronic sickers, and the immense joy surrounding most babies being born was a huge reason for my choice as well. after IM, i just wanted to see somebody who was healthy or who was gonna get better.

one downside is that the deaths and poor outcomes are a bit tougher when you do have to deal with them.

 

[DarksideAllstar]

oops, was thinking of those that looked at slides in lab. didn't think about the above.

No worries. I think the medical establishment has done a relatively poor job in actually letting medical students/residents know what pathologists do. Pathologists that perform autopsies have the responsibility of looking at the organs grossly, taking sections of each organ that may contain pathology, and then look at those sections under the microscope in order to confirm what they have seen grossly.

Praetorian- thanks for clarifying my post. Now that I look at it, I guess it could mislead people that hemepath and dermpath people do autopsies, which they dont, although I suppose that if these individuals were in private practice, they might occasionally have to.

 

[billydoc]

The only more depressing experience than death wit OB would be the malpractice rates 😡 .Damn those ambulance chacers 🙁

Good Luck with your choices. 😀

 

[Gut Shot]

oops, was thinking of those that looked at slides in lab. didn't think about the above.

Even then the pathologist is immersed in death and dying. Oh look, liver mets. What have we here? Stage III colon cancer. A Whipple on a 27 year-old? Not good! Wow, lymphovascular invasion city! Before long you feel like everyone is diseased.

 

[CANES2006]

The only more depressing experience than death wit OB would be the malpractice rates 😡

Well, I guess nothing is perfect. 😳 If it weren't for the OB malpractice everyone would want to go into OB/GYN and then the other specialties would cease to exist. 😉 😛

 

[yaah]

Even then the pathologist is immersed in death and dying. Oh look, liver mets. What have we here? Stage III colon cancer. A Whipple on a 27 year-old? Not good! Wow, lymphovascular invasion city! Before long you feel like everyone is diseased.

A lot of times previewing slides for signout takes on a few different feelings:

1) you see an interesting case like Clear Cell Sarcoma of soft tissue, say "Wow, cool," and then you realize the patient is ****ed.

2) Looking at path slides, one can categorize patients into two categories, "****ed" and "not ****ed." Like today, I have bilateral breast core biopsies on a 50 year old woman with a grade 3 (of 3) cancer so ugly you can't tell what kind it is (on both sides), lymphovascular invasion, etc. ****ed. And we also have a needle loc biopsy which just shows scar tissue and cysts. Not ****ed.

 

[penguins]

Okay, agreed with the above. But... doesn't it depend on what part of death you don't like?
You wouldn't be the one telling the patient that they are dying and you would never be involved in their DNR status or running their code, watching them die, etc.... or would you? I don't really know but I had thought not.
Clue me in. Do pathologists ever meet the slides they look at?
At what point in a path residency does one branch off to have a career of autopsies or slide/ lab work. Not to hijack the thread but I never thought about the different aspects of path.

 

[monkey7247]

Well, I guess nothing is perfect. 😳 If it weren't for the OB malpractice everyone would want to go into OB/GYN and then the other specialties would cease to exist. 😉 😛

Yeaah, that's the ticket.

 

[Gut Shot]

Looking at path slides, one can categorize patients into two categories, "****ed" and "not ****ed."

Ain't that the truth?

 

[Logos']

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[OldPsychDoc]

And nothing sucks more than pronouncing a baby. So far, that's the only death I've had to pronounce, and it sucks.

Agreed--I turned my back on Peds forever after watching an unsuccessful code on a 6 month old. Now I just deal with the depressed moms days, weeks, and months later... 🙁
Got one on my service today whose b*****d boyfriend beat her kid to death. 😡

 

[yaah]

At what point in a path residency does one branch off to have a career of autopsies or slide/ lab work. Not to hijack the thread but I never thought about the different aspects of path.

After residency you generally subspecialize somewhat. Most residents go into private practice which involves reading biopsy slides, cytology slides, and supervising laboratory issues. But others stay at big institutions or academics and focus on one specific area. In residency you are exposed to everything.

 

[sepsis]

Wow, never seen someone die, and you're nearly done with medical school? Did you do trauma with surgery? An ICU month? An IM wards month? It's not a cut or a criticism, I'm just astonished that it has happened yet. -PB

Tell ya what, I am as well. I have done 2m surg - w/o trauma and 4m medicine floors including a month of geri. I sent a pt home w/ about 1m to live and a pt on service died overnight when I wasn't on call.... so, close but that's how it goes sometimes. I'm at a large university hospital so lots of very sick people.
I had to post my experiences becuase I was just irritated at one of the responder's lack of thought. 🙁

 

[DOCTORSAIB]

Correct me if I'm wrong, but as an Ophthalmologist you're probably not going to "see" a lot of dead people....🙂

 

[NRAI2001]

GI? Allergists? Ortho? Do these guys see much "death"?

 

[Pril]

If you don't want to deal with death directly, Radiology is the way to go.