Sunday, April 4, 2010
Palliative Care For You, Serious Medicine For Me
Did you hear the one about the "palliative care" doctor who wanted more than palliative care for herself? She preached palliative care to others, but when she herself was confronted with a serious illness, she wanted nothing but the best care--no matter what the cost. It's not really a joke, of course, and it's not a funny story. But it is a revealing story.
It's the story of the late Dr. Desiree Pardi, who died of cancer last September, at the age of 41, as chronicled by Anemona Hartocollis, writing in Sunday's New York Times. Dr. Pardi was diagnosed with breast cancer a decade ago, and was saved by Serious Medicine. Whereupon she decided to specialize in "palliative care," described by Hartocollis as the "gentle gospel" of accepting mortality without engaging in heroic measures, all the while focusing on avoiding pain and getting one's affairs in order, in anticipation of death.
For decades, now, that's been a popular approach to sickness and death--at least for others.
And yet when the crunch comes, such palliative care seems not be popular with the palliators. They themselves are regarded, by themselves to be different, more deserving of care. But let the Times tell the story:
In 2008, while on vacation in Boston, she went to an emergency room with a fever. The next day, as the doctors began to understand the extent of her underlying cancer, “they asked me if I wanted palliative care to come and see me.”
She angrily refused. She had been telling other people to let go. But faced with that thought herself, at the age of 40, she wanted to fight on.
While she and her colleagues had been trained to talk about accepting death, and making it as comfortable as possible, she wanted to try treatments even if they were painful and offered only a 2 percent chance of survival. When the usual cycles of chemotherapy failed to slow the cancer, she found a doctor who would bombard her with more. She force-fed herself through a catheter and drank heavy milkshakes to keep up her weight.
So Dr. Pardi fought the good fight, for her own life, all the way to the end. It's a shame that she died so young, and a reminder that there are still victories to be won against cancer and other premature killers.
But we are also reminded that pretty much everybody thinks as Dr. Pardi did--we all want to live. Others, too, in the forefront of the "good death" movement have made similar choices, including Peter Singer, the Princeton University professor,who chose to finance long-term care for his mother, even as she declined from Alzheimer's. It's fine that Singer wants to help his mother, but he shouldn't then be able to deprive of us of the opportunity to help our mothers.
As for the cost of such Serious Medicine, as argued here at length, Serious Medicine that really works becomes Routine Medicine, and then it becomes cheap--indeed, Serious Medicine-turned-into-Routine Medicine is the beginning of a new health industry.
The point is, most of us want to fight for our lives, and for the lives of loved ones. And if we want to, we should all get that chance, to fight to the utmost.
Posted by James P. Pinkerton at 12:18 PM