Knowing exactly what to do when the time comes to make important decisions regarding the care of elderly parents is very rarely clear. There are often many difficult decisions that must be made, while still taking into consideration and respecting the wishes of the people who raised and took care of you. Joe Klein was faced with taking care of and making important medical decisions for his parents, Ensign and Miriam Klein, whose health was beginning its final decline.
This is when the health-care system came into play. At this point the Klein’s were still using health care providers provided through Medicare and Joe Klein had several questions that he wanted answers to. However, the doctors and nurses provided to the Klein’s often danced around giving the direct answers that Joe desperately sought after. Joe noticed many other deficiencies within the Medicare system: there was a lack of coordination between physicians, no screening for possible drug interactions, and patients were the main people responsible for the supervision of their overall healthcare which often caused several other medical issues. Fortunately, the Klein’s were soon transferred to Geisinger, a privately owned nursing facility, where Joe finally got the straight forward answers he had been looking for and where he was in more control of his parent’s medical treatment. His mom and dad died peacefully within six weeks of each other a few months later.
A major dilemma that Joe dealt with was whether or not he should continue medical treatment which seemed to just prolong the inevitable or if he should just accept his parent’s fate and help them pass comfortably. He felt that if the Medicare system had been more straightforward with him and was clear about the prognosis of his parents he would have not wasted the last few months of their lives attempting to prolong the inevitable by having them go through unnecessary, painful procedures. He was relieved when they were transferred to the Geisinger healthcare system because they seemed to understand what he wanted for his parents.
Although this article mostly focused on the advantages of having a privately owned cooperative type of healthcare provider, such as Geisinger, rather than the “fee-for-service Medicare” healthcare system, it strongly suggests that there is an overall need for control in the process of dying that those patients and their families seek. Joe fought for his parents to die with serenity and dignity. He felt that if he had stayed with the original Medicare plan, his parent’s death would have drawn on much longer, they would have received impersonalized care, and would have died in much more pain and with far less dignity.
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I found this article “When Doctors Grieve” that was published in the New York Times last May very interesting because it is a topic that isn’t discussed often and because I am an aspiring doctor. A study was done on twenty oncologists concerning grief practices when one of their patients died. Over half of them reported feelings of “self doubt, sadness, and powerlessness”. Many added that they felt guilty and would often cry and lose sleep. However, most of these oncologists fought to hide their emotions because it is seen as a sign of weakness as a medical professional. Surprisingly, the death of a patient oftentimes effects the behavior of the doctor and the treatment practices they perform on the patient. One doctor stated “I see an inability sometimes to stop treatment when treatment should be stopped.” This results in more aggressive chemotherapy treatments. Another aspect of this article which was of most interest to me was the idea that as a patient gets closer to dying, the doctor tends to distance themselves from the patient and their families resulting in an overall less effort toward the patient. I think this is because the doctor does not want to become too attached with the patient and develop a relationship with them because when they die, the doctor becomes affected by this both emotionally and professionally. The author of the article believes that doctors should be trained to handle their own grief and I agree. A great doctor is one that can compose themselves and carry on with their life while coping with the loss of their patient.