Survival

The other day I thought of Dylan Thomas and his poem, “Do Not Go Gentle into this Good Night.”  I really don’t know why.  The last time I encountered the poem was at the final Medical School Class Dinner in 1967.  We used it to encourage one of our favorite older surgery professors. The poem made me think about my ability and desire to survive difficult physical situations.

Movies such as The Pianist about a solitary man who survived WWII in isolation are examples.  I left the movie knowing that I would never be able to survive as he did.  The illnesses of friends and family are also examples.

A friend survived about 2 years of medical torture after a catastrophic illness caused multi-organ failure.  He was attached to a respiratory for the rest of his life and was basically unable to take more than 1 or 2 steps with assistance.  He developed colon cancer and had it resected in the middle of all this.  When he finally gave up and died a couple of weeks later, I again realized that I would not have allowed the doctors to do that to me.  Life may be precious, but it is not that precious.  You have to die sometime.

I have told my family and friends that I do not want to be kept alive if there is little or no hope of a meaningful survival.  I do not want “everything” done.  I have even suggested that every bed comes with a pillow!  A colleague kept her father alive for months demanding that everything be done.  Nurses asked me why she didn’t like her father.  It was just torturing the old man, who did die eventually.

Even Hippocrates suggests that physician understand that they cannot conquer all disease and that there is a time to “let nature take its course.”  Medicine if finally coming around to this attitude but a generation of physicians will have to pass away before it is universally accepted.  Too many really do think that they can cure every disease.