Death is a part of Medicine...how do you deal?

[OwlMyste]

I know for a fact that death is a part of Medicine. I want to know, how does each person deal with it? It must be hard...

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[md_student10021]

Most importantly, we are adults ("grown-ups" in kiddie-speak).

Next, try using proper grammar. Or do the high schools no longer teach grammar? -- one does not "deal" -- one "deals with..."
don't confuse your transitive and intransitive verbs.

my advice -- grow up. death is a part of life.

and stop asking stupid questions.

or better yet, just stop asking questions.

 

[iamubiquitous]

md_stu.............,

a little pompous but funny none the less

i concur

take flight owless

 

[jashanley]

md_student......first of all if you look owlmyste used "deal with" not "deal".......anyway, I thought it was a good, and very valid question. Doctors deal with death on a daily basis and having a patient die is difficult, especially when the patient is your own clinic patient.
As medical students, your view on death and coping with death is very different than when that patient is truly under your care as a resident and an attending. Residents and attendings have trouble sometimes coping with a patient death. The question that nearly always arises is: "what could I have done differently?"
The honest answer most often is: nothing. It was their time to die. As doctor's, we sometimes forget that death is part of a larger cycle and we feel that we can overcome and defeat death. We need to realize we might be able to postpone the inevitable for a while, but it catches up to all of us in the end. Many papers have been written on how we as physicians can learn to talk to patients about death and better cope when a patient under your care dies.
The most important things we need to learn about death are how to help the families understand when it is time to let a family member go peacefully, and how to make that patient comfortable.
Second of all, maybe you should start acting like an adult yourself. Insulting someone and telling them to grow up when you don't like their question is ridiculous and childish.
Finally, not everyone has perfect grammar, but I don't think making them aware of it helps the situation. Also, before insulting someone for making a mistake. Make sure they actually made the mistake first. If you look closely at owlmyste's statement it looks as though he/she used the proper grammar.
Owlmyste, I apologize on behalf of md_Student for his unwarranted statement.
I am interested in hearing what some residents and attendings might have to say about this topic and how they cope when a patient they knew well dies.

 

[iamubiquitous]

Jash,

lay off med stu

we went the following route with owlmyste

nice+polite----->suggested ways to get better results--->suggested better forums or threads------>gave advice------>asked nicely to minimize posts and to focus ------>pleaded with her to stop ------------> asked her nicely to leave---------->then the rudeness started when (in my opinion) it was long overdue
and only after a variety of VERY inflammatory ranting red font self entitlement monologue tantrums.

ps -- I will say something positive to Owless if you look at the title of this thread .............D E A L?

 

[OwlMyste]

Originally posted by iamubiquitous
we went the following route with owlmyste

nice+polite----->suggested ways to get better results--->suggested better forums or threads------>gave advice------>asked nicely to minimize posts and to focus ------>pleaded with her to stop ------------> asked her nicely to leave---------->then the rudeness started when (in my opinion) it was long overdue
and only after a variety of VERY inflammatory ranting red font self entitlement monologue tantrums.

IAU--I have taken all of everyones advice and taken it into consideration, and will do, but that doesn't mean that the questions will stop! hell, patients have even more questions than I do, and by far more bizzare! I should know, I was once or twice a patient in the hospital, once when i had surgery to correct the cleft in my soft pallette, and the other time to get tubes in my ears...and if you're like this to me....i shudder to think what your bedside manner to your patients, if any, that you have! because your negative, belittling, deroggatory, attitude can use some adjusting! and by the way--I deleted the red font post, so stop bringing up old stuff!!

by the way...is it your mission on this post to try to turn everyone who posts here against me...?

 

[jashanley]

iam---sorry but I don't frequent the surgical forum often enough to notice who is annoying who etc..... I have been flipping throught the pages to see the extent of damage owlmyste has done and it does seem to be extensive.
I liked his/her question and had she/he asked it without thousands of other posts it might have stimulated a good discussion.
I read in another post that she might benefit from researching the answers herself and I do agree with that statement.

 

[OwlMyste]

Originally posted by jashanley
iam---sorry but I don't frequent the surgical forum often enough to notice who is annoying who etc..... I have been flipping throught the pages to see the extent of damage owlmyste has done and it does seem to be extensive.
I liked his/her question and had she/he asked it without thousands of other posts it might have stimulated a good discussion.
I read in another post that she might benefit from researching the answers herself and I do agree with that statement.

Jash,

How have I caused damage? Since when can asking multiple questions in multiple cause extensive damage?I only posted a few posts, since when was that ever a crime? I asked what I thought were good questions! And I did start by just one post, but I want more than just one discussion...lest I be yelled at for changing the subject in my supposedly only one allowed post...I thought this was supposed to be a forum where people can ask questions, even if on multiple posts, get them answered, but not get yelled at or looked down upon..(not that you are looking down upon me...) if more questions are to arise...it's just me...I'm a very inquizitive person, it's just my nature...I thought ppl were supposed to encourage questions, even if they may seem annoying to that person whose being asked the Q, it doesn't sound ******ed or stupid to the person that asks it...

 

[hotbovie]

Remember that when you start med school, one of your first classes is gross anatomy, in which you dissect a cadaver. This is often the first time that many students have seen a dead person, and starting the class can be an emotional experience for some people. YOu soon get used to it though, as you get down to the business of dissecting and learning.

Once you hit the clincal area, it may be some time before you have the experince of one of your patients dying. Many students don't. However, some do. Most often, it would be that you come in one morning to learn you patient died overnight. Other times, you might witness a death if your team responds to a code in the hospital. The patient isn't yours, or on your team, and you watch while the code is run and then finally called.

If you do any time in the ICU, you will expereince death as a student. How you feel about it depends on the circumstances. If the patient is an elderly person with multiple medical problems who got very sick and then developed multiple organ failure, death is often seen as a good thing, and end to their suffering. Many times the team is ready for death before the pts family is. You'll know this because the residents will say that the pt should be made DNR (do not recussitate) but the family isn't ready to do that. Sometimes the family decides that the pt had a good life and is ready to go and will instigate a DNR request themselves.

Another sceniario is a younger patient with a bad disease, such as metastatic cancer. THeir death is a little harder, becuase they are young, but still usually you can think of it as an end to suffering.

I think the hardest to handle are the young, heathly patients who have some sudden catastrophe, like trauma. For those kinds of patients, it's hard to feel in any way that the death can serve a good purpose.

Like anything else, though, you get used to death with time. YOu will find, if you get into med school and do a residency, that there will be many instances in which you feel uncomfortable at first, but then later that situtation seems normal. Take the ICU, for example. The first time you go in, it's very intimidating, with all the machines and gizmos and alarms going off. However, you get used to it, and it becomes a normal environement for you to work in. Kind of the same thing with death. It gets easier, generally, with time. You kind of have to put your thoughts about it aside for the day becuase there is work to be done. Some will linger with you longer than others, say, when you go home that night.


Now, I'd like to address some of the other issues that have been brought up in this thread. Owl, you do have some valid questions, and gererally people here are happy to answer the questions of high school students (or anyone else, for that matter). That's not the problem. Look at both the surgery and general residency boards, and see how many threads have been started by different posters. You will see that you have started FAR more than anyone else, even folks who have been participating here for years. You've only been a presence for a few weeks, yet you are already becoming notorious on this forum. And in many of the questions you are getting way to far ahead of yourself (example are questions such as the competitiveness of various surgical residencies...things like that could change significantly over the next 8 years). YOu have, at times, come across as spoiled and immature and sometimes sound like you are demanding that we answer your questions. Combine that with the fact that you seem to be determined to monopoize these forums, no wonder people are annoyed, and becoming increasingly so. Now before you fire off an angry reply to me, notice that I said this behaviour is occuring SOMETIMES and that you have valid questions and people want to help.


Some people have tried to gently point out these behaviours to you, and you haven't seemed to have taken it well. Thus replies are becoming more obnoxious (not appropriate, I grant, and people older than 19 can also demonstrate epsoisodes of immaurity).

You'd do well to reign it in on this forum. That dosen't mean don't post at all. Just try to focus on the issues that are closer at hand. Some of your posts are quite good and show you are intellignet and capable. Other posts sound like the rantings of an immature spoiled teenager. Learn to filter those things now. (Attitude and marturity are a large part of your clincial GRADES in medical school) There are plenty of other places to get answers to many of your questions. Plus you really need to try not to get so far ahead of yourself. I think it's good that you are foward thinking (when I give tours at my medical school, I'm shocked at the number of people who are interviewing who don't know that you have to do a residency after medical school). You should know some of the basics for the path of the career you are interested in. However, you are getting too far ahead in the level of detail. When I was 19 (some 23 years ago!) I knew about residencies, and even knew when a brand new one came out (emergency medicine). However, I was focusing more on things like what the med school application process was like, what the MCAT was like, and trying to get good extracurricular activites for my med school application. Why I wound up not making it to med school unti a full 20 years after I graduated high school is a long story, explaned largely by my lack of focusing on my studies in undergrad which resulted in a dismal GPA. Don't head down that path by getting to hung up on details of things you may or may not be doing in 8 years.

 

[iamubiquitous]

Originally posted by jashanley
iam---sorry but I don't frequent the surgical forum often enough to notice who is annoying who etc..... I have been flipping throught the pages to see the extent of damage owlmyste has done and it does seem to be extensive.
I liked his/her question and had she/he asked it without thousands of other posts it might have stimulated a good discussion.
I read in another post that she might benefit from researching the answers herself and I do agree with that statement.

Jash: I understand-- no biggie.

Owl: I wasn't talking to you.


IMU

 

[BeeGee]

Like the previous post, dealing with death is worst with the young. So much freakin potential... gone. I wonder about their families, friends, coworkers... These thoughts would go on for a while when i experienced my first code but like anything, if u see it enough, its easier to tolerate; although you're never completely comfortable with it.
Worst case for me was during my 3rd yr of med school when i was to do the H&P for a 29 yo women with CP in the ER. Well, she was worked up as post MI and placed on the regular floor w/ minimal SOB and i think i had a lecture for the rest of the day. I went back to her room about 7pm before I left for the day, just to be a good med student and we talked about the weather, the city, her interests, family, and a lot of things....
Sure enough, i came in the next day and this young pt died. A cardiac cath was performed before i got in, found an aortic dissection, and the pt coded and died.
It takes a while to get over the 1st death, especially if that 1st is a young pt, but after that, the steady body count doesnt spoil your day completely. I deal with it in my own way; prayer, respect, and move on. You have many other pts to take care of and many more you might be able to save.
I try to learn something from death, preventing it when possible, or make it easier for my pts to tolerate if its inevitable.

 

[OwlMyste]

Originally posted by hotbovie
Remember that when you start med school, one of your first classes is gross anatomy, in which you dissect a cadaver. This is often the first time that many students have seen a dead person, and starting the class can be an emotional experience for some people. YOu soon get used to it though, as you get down to the business of dissecting and learning.

Once you hit the clincal area, it may be some time before you have the experince of one of your patients dying. Many students don't. However, some do. Most often, it would be that you come in one morning to learn you patient died overnight. Other times, you might witness a death if your team responds to a code in the hospital. The patient isn't yours, or on your team, and you watch while the code is run and then finally called.

If you do any time in the ICU, you will expereince death as a student. How you feel about it depends on the circumstances. If the patient is an elderly person with multiple medical problems who got very sick and then developed multiple organ failure, death is often seen as a good thing, and end to their suffering. Many times the team is ready for death before the pts family is. You'll know this because the residents will say that the pt should be made DNR (do not recussitate) but the family isn't ready to do that. Sometimes the family decides that the pt had a good life and is ready to go and will instigate a DNR request themselves.

Another sceniario is a younger patient with a bad disease, such as metastatic cancer. THeir death is a little harder, becuase they are young, but still usually you can think of it as an end to suffering.

I think the hardest to handle are the young, heathly patients who have some sudden catastrophe, like trauma. For those kinds of patients, it's hard to feel in any way that the death can serve a good purpose.

Like anything else, though, you get used to death with time. YOu will find, if you get into med school and do a residency, that there will be many instances in which you feel uncomfortable at first, but then later that situtation seems normal. Take the ICU, for example. The first time you go in, it's very intimidating, with all the machines and gizmos and alarms going off. However, you get used to it, and it becomes a normal environement for you to work in. Kind of the same thing with death. It gets easier, generally, with time. You kind of have to put your thoughts about it aside for the day becuase there is work to be done. Some will linger with you longer than others, say, when you go home that night.


Now, I'd like to address some of the other issues that have been brought up in this thread. Owl, you do have some valid questions, and gererally people here are happy to answer the questions of high school students (or anyone else, for that matter). That's not the problem. Look at both the surgery and general residency boards, and see how many threads have been started by different posters. You will see that you have started FAR more than anyone else, even folks who have been participating here for years. You've only been a presence for a few weeks, yet you are already becoming notorious on this forum. And in many of the questions you are getting way to far ahead of yourself (example are questions such as the competitiveness of various surgical residencies...things like that could change significantly over the next 8 years). YOu have, at times, come across as spoiled and immature and sometimes sound like you are demanding that we answer your questions. Combine that with the fact that you seem to be determined to monopoize these forums, no wonder people are annoyed, and becoming increasingly so. Now before you fire off an angry reply to me, notice that I said this behaviour is occuring SOMETIMES and that you have valid questions and people want to help.


Some people have tried to gently point out these behaviours to you, and you haven't seemed to have taken it well. Thus replies are becoming more obnoxious (not appropriate, I grant, and people older than 19 can also demonstrate epsoisodes of immaurity).

You'd do well to reign it in on this forum. That dosen't mean don't post at all. Just try to focus on the issues that are closer at hand. Some of your posts are quite good and show you are intellignet and capable. Other posts sound like the rantings of an immature spoiled teenager. Learn to filter those things now. (Attitude and marturity are a large part of your clincial GRADES in medical school) There are plenty of other places to get answers to many of your questions. Plus you really need to try not to get so far ahead of yourself. I think it's good that you are foward thinking (when I give tours at my medical school, I'm shocked at the number of people who are interviewing who don't know that you have to do a residency after medical school). You should know some of the basics for the path of the career you are interested in. However, you are getting too far ahead in the level of detail. When I was 19 (some 23 years ago!) I knew about residencies, and even knew when a brand new one came out (emergency medicine). However, I was focusing more on things like what the med school application process was like, what the MCAT was like, and trying to get good extracurricular activites for my med school application. Why I wound up not making it to med school unti a full 20 years after I graduated high school is a long story, explaned largely by my lack of focusing on my studies in undergrad which resulted in a dismal GPA. Don't head down that path by getting to hung up on details of things you may or may not be doing in 8 years.

I know I prolly have gotten carried away at times, yes...and thanks for telling me I have valid questions...for some ppl here say all of my questions are unvalid...if you look now at the posts, I have deleted most of them...it's just that I thought that I would hafta post numerous postings for different discussions...lest i be yelled at for changing the subject in my posts...(it has happened b4...not necessarily here...but it has happened b4...)...but i didnt know that posting questions was a sign of immaturity...i thought i was supposed to post multiple questions...it's just that I'm so used to people not listening to me or my questions that I have thought I hafta post alot to get more noticed...

I have seen a documentary on med school on discovery health channel, and gross anatomy was by far, very interesting...I have seen death many times...been to many funerals, even that of a close cousin who had to be buried on his 17th birthday...I was also there when my grandfather died, I saw that live...so I have seen death and had more than my share of personal loss...and we did have my grandfather on DNR....oh..and I wouldn't fire off an angry reply at you... ...thus why I created this post...because different doctors deal with death differently, and I wanted to get an honest opinion from actual docs and med students/residents who have had the experience...as this is also an interesting subject...

oh...by the way..I have a Q for you...I was reading a post in surgeons peeing on themselves, where a med student let one rip in the OR because he had bad gas...and the surgeon laughed and said to stay away from the bovie.....so I am asking...what's a bovie?

 

[mikecwru]

oh...by the way..I have a Q for you...I was reading a post in surgeons peeing on themselves, where a med student let one rip in the OR because he had bad gas...and the surgeon laughed and said to stay away from the bovie.....so I am asking...what's a bovie? [/B]

A bovie is a big knife used by Australians.

I don't know of any other definition. Maybe you should look it up and let us know what you find.

mike

 

[iamubiquitous]

mike: right on

owl: congrats on becoming a full member

 

[OwlMyste]

Originally posted by iamubiquitous
mike: right on

owl: congrats on becoming a full member

mike: thanks for clearing up my confusion on a bovie...

IAU: thanks