The Art of Medicine

T6430parallelbarsThis post takes in considerations of end of life and midlife care. I believe it’s not until we can comfortably consider life and death as part of the same thing (that’s going to come to us all) that we’ll never truly do the best for people who need our help. Think Hakuna Matata and the circle of life if it makes it any easier!

We’ve had quite a time to think of medicine purely in scientific terms but a good doctor is so much more than a trained health professional enthusiastically dishing out antibiotics.

“Andrea Williams, the chief executive of the Christian lobby group Christian Concern, led criticism of Ashton. “To say that it’s care for a doctor to kill is … a complete denial of their Hippocratic oath,” she said. “A doctor is there to care for the patient, not to kill the patient. Midwives joyfully bring life into the world. It’s not a doctor’s place to play God at the end of life.”

The words above were in an article in the Guardian on recent pronouncements of retired health professional, Prof John Ashton. He has held a number of positions advising on the role of medicine in our society to governments of the day.

I think Ms William’s stance on the meaning of the Hippocratic Oath perhaps accounts for why the NHS believe that they’re winning so long as their patients aren’t dying.

Life is more than a binary process: either being alive or dead.

“First do no harm” is the part of the Oath that got spouted at me when i spoke with either GPs or my neurologist about the theory of CCSVI. It believes that narrowed veins in and around the head lead to a slowing down of blood and a resulting de-oxygenation of blood feeding the brain. This lowered O2 can lead to slowed mental processes, lowered mental acuity and low mood.

If we acknowledge that potentially reversing this process is within a medical professional’s ability to reduce this activity then are these professionals not actively doing harm in doing nothing?

How did coronary angioplasty ever get past the First, do no Harm rule for folk suffering from narrowed arteries around the heart? This rule was flouted because it could be seen by a medical professional in the late 70s treating someone with a heart attack that widening the tubes around the patient’s heart would give some relief to the effects of angina even if the procedure did involve breaking his skin at the top of the thigh.

It’s apparently not considered a major incision so that takes care of that flouting then!

Back to Ms Williams’ feelings: I believe it’s the healthy person’s fear that lies at the heart of extending life at any cost. Quality of Life is more important to the patient than it is to anyone around them.

Even the best, most caring nurses who have chosen the vocation of nursing which is all about the compassionate care of others can’t care about their patient’s wellbeing more than the patients themselves.

The ill live in their body 24/7. Their experience of their body doesn’t involve being accessible by means of an emergency buzzer or cord. Facing up to the quality of that life forces us to face our own mortality. I believe it’s cowardice that’s helped us to this predicament.

An unwillingness to face our own mortality perhaps explains why we seem to put an uncomfortably high proportion of the total NHS spend toward paying for drugs rather than ensure more patients have a comfortable death?

I’ve not checked out the statistics but it seems once we face up to what’s going to come to us all we can better prepare for the ones facing the inevitable, sooner.

This clip from Canadian TV was also at the back of head whilst writing this post