Why doctors die differently

There's an important and telling article in yesterday's Wall Street Journal by a medical doctor about why most doctors don't choose heroic measures when facing terminal illness, and instead prepare "advanced directives" about what they want.

"It's not something that we like to talk about, but doctors die, too. What's unusual about them is not how much treatment they get compared with most Americans, but how little. They know exactly what is going to happen, they know the choices, and they generally have access to any sort of medical care that they could want. But they tend to go serenely and gently."

The article suggests, and the reader comments confirm, that while the hippocratic oath is a real and meaningful commitment, the mix of for profit hospitals, doctors, lawyers and the potential for abuse of Medicare and Medicaid, conspire to lead many elderly patients and their families to make the wrong choices.

"In a 2003 article, Joseph J. Gallo and others looked at what physicians want when it comes to end-of-life decisions. In a survey of 765 doctors, they found that 64% had created an advanced directive—specifying what steps should and should not be taken to save their lives should they become incapacitated. That compares to only about 20% for the general public.

"The result is that more people receive futile "lifesaving" care, and fewer people die at home than did, say, 60 years ago. Nursing professor Karen Kehl, in an article called "Moving Toward Peace: An Analysis of the Concept of a Good Death," ranked the attributes of a graceful death, among them: being comfortable and in control, having a sense of closure, making the most of relationships and having family involved in care. Hospitals today provide few of these qualities."

I was not the sixth Beatle

All 288 of Bart Simpson's chalkboard admonitions.

Flash

OK, I'm an iPad 2 and iPhone 4S fan boy.  And I'm wondering, will new Apple CEO Tim Cook end the company's silly boycott of Adobe Flash?

Valentines

R. J. Shaughnessy, “Heart” (2004)

Nikolai Recke, “Parklove,” from the series “Lovebirds” (2009)

Imported from Detroit Redux

Moving On

I was saddened to read of the death last Friday of Wall Street Journal writer Jeff Zazlow, after a collision with a truck on a snowy road in northern Michigan.  His Moving On column had been a source of comfort to me when my brother passed away in 2002.

Zazlow had a way of writing about love, loss and transition that was uniquely empathetic but never sentimental.  He's perhaps best known for his column about the late Carnegie Mellon engineering professor Randy Pausch, which led to the book The Last Lecture.

The column I remember most was one he wrote about dreams about the dead and how their visits, real or not, help survivors cope and come to terms with loss.

An excerpt:

"Every night, millions of people are visited by deceased loved ones. In dreams, the living and the dead embrace, converse and reach understandings. What are we to make of these encounters? Are they merely emotional responses to dreamers' grief? Or, as research suggests, are there patterns to these dreams that could explain the inexplicable?"

A Thousand Words

More bad news today from Kodak.  As the company teeters on bankruptcy, Kodak announced they're exiting the camera business, a technology they innovated since the 1880s, along with photographic film.  There's no mention of today's news on A Thousand Words, a blog by and for Kodak employees. 


I remember my first camera, the Kodak Instamatic 104 with its Sylvania Blue Dot Flashcubes.  It was a gift from my parents, along with a dozen 126 film cartridges, as we embarked from Connecticut on a February 1967 school break to Washington, DC and Williamsburg, Virginia, which was a family rite of passage when you turned 10.  My older brother had turned 10 the summer before.

I just paged through my photo album from that trip. Lots of the kinds of pictures you'd imagine a nine year old would take . . . Washington Monument (crooked), House of Representatives (crooked in every sense of the word), the Lincoln Memorial, etc.  There was a whole page of snap shots of the magazine at Williamsburg, including one taken the moment the cannon fired.  That one's crooked too, and blurry. 

My other distinct memory of the trip was the fierce ice storm that befell New England and the mid-Atlantic states during our trip.  This storm was the backdrop of the 1960s marital and family distress in the Ang Lee movie The Ice Storm, filmed in New Canaan near my hometown.

Here's a cheerier depiction of that era.  It's new, it's now!  It's Flash Cube! Flash Cube?