Hw 30

To find out if what we learned about the dominant social practices around illness & dying in a hospital were true I interviewed a doctor about how they feel and handle illness & death in their hospital. In class, we saw Near-Death a documentary about how doctors handle death with their patients. From the movie we found that doctors provide false hope for patients, don’t ask them how they want to die, talk to family members behind their backs and have important meetings about patients in the open. I decided to see if doctors really do these things so I interviewed a close friend of mine, Patricia Burns, an Assistant Attending Assistant Professor at Weill Cornell Hospital, about how she handles illness & death in her hospital.


Patricia Burns
Assistant Attending Assistant Professor at Weill Cornell Hospital


Q: Do you see illness and death at your job?

A: I see illness everyday but not much death in my field of work.

Q: If a patient of yours dies in the hospital how do you handle it?

A: First, I help the person’s family handle the immediate issue of death. Then I try to find out their religious beliefs so I know how to act next. I then give them space so they are able to let their emotions out but if they can’t accept what just happened. I try to introduce them to the idea that death is one stage in life everyone goes through.

Q: Now, personally, how do you handle the death of a patient?

A: I have different relationships with different patients. I feel closer to some patients than others; it also matters how long I have had the patient under my care. I feel it’s alright for doctors to feel sad about a patients death but I also feel it’s important that a doctor’s sadness doesn’t get in the way of their job. I can share my feelings and talk with my family. In the moment, it’s an opportunity that belongs to the patient's family. I may shed a tear but I don’t want to impose on people’s feelings.

Q: How is how you handle death different from your co-workers?

A: It affects each person differently. Ssome people choose to feel nothing and other people make it part of their life. I work in the woman’s imaging field at the hospital and I do procedures on women who might have or have had breast cancer. Nurses that have had breast cancer before sometimes have a hard time not telling their story to every patient that walks in. I think it’s bad for nurses to tell stories about when they were sick because it’s not their time to be heard it’s the patient’s time to act and let their feeling out. I also think this affects nurses abilities to do their job well because they want to talk about what happen to them instead of listening to the patient. 

Q: Do you lie to your patients?

A: No, I don’t ever lie to my patients. Sometimes I have them focus on positive things before a biopsy comes back because I might have a good idea of what the outcome will be and if I feel they may not be mentally ready for the truth. I tell them we are taking one step at a time and if there is an issue you and your doctor will talk about it. A lot of times its better to give a person a week to think of what could happen and maybe be a little more open that the test results could come back positive.

Q: When a patient is on their deathbed do you ever refrain from telling them the whole truth and give them false hope?

A: I never gave false hope to a patient that I know would not live. If I am in the situation I say it in a polite way. If they ask me if its time to call their family I say if it were me I think at this point I would. Also, often around the time of death a patient is no longer mentally present.

Q: Do you talk to your patients about how they want to die?

A: I saw people in the hospital on their deathbeds when I was interning and doing my residency at hospitals. The doctors and I would talk through different options with the patients so they were well informed. When talking to the patients we would explain the medical terms so they fully understood what we are talking about. Then we would have a family meeting where we go through what the patient want to do. But some times the patient and their family don’t see eye to eye. No matter, what I have to do what the patient wants.

Q: What do you do if you think a patient is making the wrong choice by giving up?

A: Patients choose what they want to do first but if I feel they are making a bad choice I explain everything the best way I can. I also look if the patient is depressed because; if so, it might be impairing their judgment and they can get help for that first. That’s what I think happened to my sister.

Q: Is talking about a patient around the halls common?

A: Most times if we our talking about a certain patient we go to inner dispensary conferences where we talk privately with the patient’s doctor and other professionals in the field helping on the case about what direction to take next.

After my interview with Dr. Burns I saw major differences from how the movie portrayed doctors and how Dr. Burns portrayed herself and her colleagues. Dr. Burns stated that she does not practice giving false hope to her patients but helps them handle the pain they are feeling. I also found that Dr. Burns asks her patients how they want to die unlike in Near-Death but this can now happen in all hospitals because President Obama is trying to make this option open to all patients in America. He proposed giving doctors a bonus for talking to their patients about death. “2011 would let the government pay doctors who discussed end-of-life care options with their patients during annual visits.” (TOWEY 1

I also learned that family members are just informed about their loved ones and not given any power over their well being and when a patient is talked about with other doctors its behind a closed door so the patient's  privacy is respected. This makes me feel better about hospitals. One of the most interesting things I learned is that a patient can be depressed before death, which can alter an end of life decision.

This interview shows me, that in the last decade, that the dominant social practices of illness & dying have changed a great deal in our hospitals. This change is for the better because it means we are caring for our patients in a more humanistic way. I enjoyed studying this subject because it made me feel better about going to hospitals.

Bibliography

TOWEY, JIM. "Obama's end-of-life bungling." New York Post (2011): 1. Web. 18 Jan 2011. <http://www.nypost.com/p/news/opinion/opedcolumnists/obama_end_of_life_bungling_M3v6alI9iFO7cZETf5ZqJO>.