I have written many essays over the past couple of years about a former colleague of mine when I was a young, fair-haired youth a half century ago. She knows me well enough that all that she has to do is to mention something that I might like to read before I will jump at it like a piranha would jump at a chunk of meat thrown into a pond.

A couple weeks ago, my friend mentioned Being Mortal by Atul Gawande and added that I might get something out of the book. A couple of years ago, she gave me, A Music Lover’s Diary which resulted in the link to the section on Friedrich Nietzsche under Critical Issues.

My colleague’s comment resulted in me ordering the book from Amazon. Dr. Atul Gawande got his medical degrees at Harvard and is a surgeon at Brigham and Women’s Hospital in Boston and teaches at Harvard Medical School and the Harvard School of Public Health.

Dr. Gawande

As I read Gawande, I realized that we had a litany of thoughts that we share regarding medicine. For example, it seems to me that the part of the Hippocratic Oath that medical students to which they pledge before they become doctors, primum non nocere (first, do no harm) needs to be rethought. Hippocrates was born in ancient Greece two and a half millennia ago. His oath was sworn to Apollo. Therefore, it has been revised over time. Gawande and I share the desire to revise the oath to fit our needs of the 21st century. The most important one is to rethink the mantra, to do no harm.

Hippocrates

Gawande’s deal with this issue is from the position that doctors should address a good way to live life than providing longevity to their patients facing old age. Longevity can be harmful to many patients. Gawande wants doctors to be honest with the patient so that the physician and patient are dealing with what the patient needs and not to do harm to that patient. The quality of life of the patient is the summum bonum not the primum non nocere.

Nursing homes have become places where people are often housed and merely kept alive. Interestingly, nursing homes during the COVID-19 pandemic are often where the mortality rate is many times higher than those not housed in nursing homes. However, even before the coronavirus swept through America, nursing homes were essentially waiting rooms for the residents to die.

I want to personalize that generic description of nursing homes. My story is about being not in a nursing home but a rehab hospital for a month after being in ICU for a month. Twelve years ago, I fell off a ladder and had a traumatic brain injury. I don’t recall the fall, going to the hospital, going to the rehab hospital, and only remember the last ten days there. I was there recovering from my fall, fortunately.

However, to relieve the swelling of my brain due to my fall, the neurosurgeon removed a bagel-size part of my skull for over two months. Essentially, the rehab hospital wanted to protect me from falling and worsening my brain injury. I wore something like a football helmet and was put in a padded playpen, which they zipped the top closed so that I didn’t climb out.

I can recall that feeling of being caged in…even today. I felt helpless. There wasn’t anything that I could do to escape. I knew what claustrophobia felt like. Even writing about it a dozen years after that incident brings back some of my fears and feelings. Imagine being in a nursing home for years knowing that you were there until you die and had no means to escape.

Gawande also deals with the patient’s right to die. People near their final days should have the ability to say, “I don’t want to continue….” Man, I understand that feeling even though I want to continue until I decide not to live any longer.

Yet, we have doctors and families deciding for people, what they will have to endure. That is abusive behavior from people who claim they want to help the person. Euthanasia is a bad word according to many people. Nevertheless, why do we allow others to decide what is best for someone who can’t recover and who will have to sit or lie around for months or even years? I wonder what those that diss euthanasia today would feel like if they were suffering without any means to improve their situation.

One final item. I have had for several years told my family that when I die that I want them to have my remains sent to the University of Chicago’s medical school. It was the U. of Chicago Hospital that saved my life a dozen years ago. In an educational way, I will have some sort of semblance of immortality by helping medical students learn. I would be teaching at the University of Chicago’s medical school after I had died.

---

This is the organization in Chicago in which I am registered.

Follow @mountain_and_me