1/🧵 A personal story of misjudgment as a physician.
Years ago, when I was a young doctor, I had a patient in the ICU on a ventilator who was doing so poorly, day after day, that I was certain he was going to die.
I confidently told the family he was going to die.
Years ago, when I was a young doctor, I had a patient in the ICU on a ventilator who was doing so poorly, day after day, that I was certain he was going to die.
I confidently told the family he was going to die.
2/ The family members all gathered and were extremely distraught. They listened and trusted me.
But I was wrong.
#PalliativeCare #EndofLife
But I was wrong.
#PalliativeCare #EndofLife
3/ For many years to come, I received Christmas cards from this man.
It was extremely humbling.
Until I learned, this happened many other times in my life as an ICU doctor.
Sometimes I was off by just 2 weeks, sometimes 2 months, and other times by 2 years.
It was extremely humbling.
Until I learned, this happened many other times in my life as an ICU doctor.
Sometimes I was off by just 2 weeks, sometimes 2 months, and other times by 2 years.
4/ I no longer predict how long someone will live.
Instead, when the family or a patient inevitably asks me this question, I “flip it.”
I admit that I honestly don’t know how long s/he will live.
Yet for those severely ill, I prepare them for how quickly death ‘may’ occur.
Instead, when the family or a patient inevitably asks me this question, I “flip it.”
I admit that I honestly don’t know how long s/he will live.
Yet for those severely ill, I prepare them for how quickly death ‘may’ occur.
5/ This “flipping it” both maintains #hope & also helps people become realistic about how sick someone is so that they can mentally prepare and communicate appropriately with one another.
See my entire 🧵👇 on this topic…
See my entire 🧵👇 on this topic…
https://twitter.com/weselymd/status/1284536666854572032
6/ I’m amazed by the number of things during the dying process that often happen in someone’s life to bring long-awaited healing (even without cure) for patients & everyone in their love circle.
To me it’s evidence that we are all greater than the sum of our parts.
To me it’s evidence that we are all greater than the sum of our parts.
7/ During people’s dying process – be it hours, days, months, or years – people deserve to have dignity respected & the entire process honored.
In accordance with many patients’ wishes, we regularly remove ventilators & other life support as part of the natural process of dying.
In accordance with many patients’ wishes, we regularly remove ventilators & other life support as part of the natural process of dying.
8/fin
My “Christmas Card” patient never once chided me for predicting (wrongly) his death.
Instead, we became very close. He helped me shed bad prognostication habits & more than a smidge of pride.
Our patients lead us.
I’d love to hear any lessons you have on this topic.
My “Christmas Card” patient never once chided me for predicting (wrongly) his death.
Instead, we became very close. He helped me shed bad prognostication habits & more than a smidge of pride.
Our patients lead us.
I’d love to hear any lessons you have on this topic.
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