Who knew that discussions about code status could be entertaining and educational? Absurdly Rational host, that is. Great post - my only quibble is listing someone as "a DNR" has a long evidence based history of be equated with a false identity based on willingness for an intervention - esp when the corollary takes over "DNR = DNT (Do Not Treat)".
I completely agree that “do not treat” is a big problem despite the fact that it’s not really a thing. I was winding up to discuss that too -given Gertrude’s lack of pre-op risk stratification, but I struggle to keep my stuff brief. I mean… it isn’t brief at all. So I was planning on covering that very issue once I make this into a podcast. Perhaps we can tackle it together, since it’s as near and dear to your heart as well?
Yes I would love to collaborate on this - I am steeped in this topic as you correctly perceive - I have become a de facto palliative care physician as a result. Interestingly, there are data - mostly from trainees, that DNR designation does in fact lead to lower adherence to following quality-based medical recommendations, and anecdotally, I hear physicians conflate the two all the time, Maybe our surgical and anesthesiology colleagues do better on this score than medical ones :0
A close relative recently suffered a stroke. Remained coherent verbally but lost all sense of balance: she could neither stand nor stand unassisted. Was gonna be a long rehab. A few days later, while still in hospital, she suffered a major heart attack. Her DNR was ignored, I suspect because she wasn’t there for the heart attack. She was resuscitated but came out of it vegetative, placing us in the position of making the decision the DNR was in place to preclude. When this was pointed out to the medical staff, they were indignant. “Would she not even want CPR?” one said. NO! That was the point of the DNR. But no, American medical staff are trained to extend life no matter what and family have to constantly advocate & intervene with people who think they know better.
“We will forcibly squish it around your body…”. There was a post in the last several days that described CPR in detail by a healthcare worker. It was horrifying. And the success rate was abysmally low. I can see why people opt out.
I think to myself, just let me go when it's my time.....I'm so tired.
Then, I choke on my beverage, and my first thought is, HALLLLLLLPPPPP!!!
Who knew that discussions about code status could be entertaining and educational? Absurdly Rational host, that is. Great post - my only quibble is listing someone as "a DNR" has a long evidence based history of be equated with a false identity based on willingness for an intervention - esp when the corollary takes over "DNR = DNT (Do Not Treat)".
I completely agree that “do not treat” is a big problem despite the fact that it’s not really a thing. I was winding up to discuss that too -given Gertrude’s lack of pre-op risk stratification, but I struggle to keep my stuff brief. I mean… it isn’t brief at all. So I was planning on covering that very issue once I make this into a podcast. Perhaps we can tackle it together, since it’s as near and dear to your heart as well?
Yes I would love to collaborate on this - I am steeped in this topic as you correctly perceive - I have become a de facto palliative care physician as a result. Interestingly, there are data - mostly from trainees, that DNR designation does in fact lead to lower adherence to following quality-based medical recommendations, and anecdotally, I hear physicians conflate the two all the time, Maybe our surgical and anesthesiology colleagues do better on this score than medical ones :0
Hoping I can go while jogging.
I despise jogging so much that I hope to depart whenever I’m jogging too.
LOL.
Pick something you LIKE doing.
Oh, this piece is ridiculously good.
The tv program Dead Like Me was grossly underrated and profound.
A close relative recently suffered a stroke. Remained coherent verbally but lost all sense of balance: she could neither stand nor stand unassisted. Was gonna be a long rehab. A few days later, while still in hospital, she suffered a major heart attack. Her DNR was ignored, I suspect because she wasn’t there for the heart attack. She was resuscitated but came out of it vegetative, placing us in the position of making the decision the DNR was in place to preclude. When this was pointed out to the medical staff, they were indignant. “Would she not even want CPR?” one said. NO! That was the point of the DNR. But no, American medical staff are trained to extend life no matter what and family have to constantly advocate & intervene with people who think they know better.
This is the big fear
How do I encode "Save me if there's a chance I can earn money and pay back my medical bills"?
If you die without paying your bills, you win!
"Forcibly squish your blood around." Using this for when I teach my next cpr course. 😂
I found this interesting but also confusing so what I want is just a statistical report on non-religious doctors on what they have for themselves
“We will forcibly squish it around your body…”. There was a post in the last several days that described CPR in detail by a healthcare worker. It was horrifying. And the success rate was abysmally low. I can see why people opt out.
The only tattoo I am planning….do not resuscitate across my chest with my signature.
Hospitals might be haunted by the souls of the departed, moaning, "Where was the smart aleck with the pictures when I needed them?"
Wow! Who knew dying could be so messy & complicated?!?!?! Yikes!