Monday, July 20, 2009

MedSpeak

This morning, my wife and I were commenting about the unfortunate case of her sister's mother in law, who, at 95, had been pronounced 'effectively dead', being kept on life support until her son and daughter could get to the hospital -- and who, upon being removed, continued to live, much to the surprise and chagrin of those involved. No body wants to say 'Die, already!', but that's the sense of it. It's bad news, she said. Yes, I replied, and expensive, too. She agreed, saying that studies repeatedly show that the average per-year cost of health care goes up dramatically in the final years of life. That's why the Republican health care plan makes so much sense, I said. They send out dapper young men and women who would roam the country, looking for elderly, feeble, and relatively indigent people whose whole aspect suggests that they're in those final years -- and kill them. And you know, I can almost believe that. Dick Cheney, say, would say gruffly that it was an elegant and cost-effective solution -- but don't tell anyone, in particular the Congress.

We're having our own version of that, as my mother is having problems with water retention, which means she likely needs to increase her diuretic, which means her blood pressure will go down (dizziness), which means she will likely need to decrease the blood-pressure-dropping drug she takes now, which means that it'll become too high at least until the new level is figured out. I told my wife that our discussing this was like most doctors, who treat the eighty or so percent of standard cases the same way -- you could be getting treated by the receptionist, working from a cheat sheet, I thought. And if if were my mother's cardiologist, I added, he'd be saying 'well, here's what I want to do, what do you think' . Sometimes, he'd cut directly to 'what do you want to do?' Quite exasperating. Medically interesting, but, um, guy? Isn't that why you get the big bucks?

2 comments:

Tabor said...

I think the doctor is asking you which bad alternative are you willing to deal with as there is no easy solution.

Cerulean Bill said...

I'd like to believe that, but when he starts out with "What do you want to do", and you have to encourage him to increase one med, decrease another, or have a test done, it's hard not to feel that he's trying to pass the malpractice buck.