April 28, 2010 Leave a comment
I am writing early today because it is a Wednesday – long hours of class immediately followed by an ED shift. I am quite disenchanted with medicine at the current moment. I can hardly be excited about vacation when I know that I will be postponing an ATLS course until later this year because of it, and that I will be returning to one month in the MICU. I have had trepidation about the MICU since I was a medical student. I cancelled my medical school rotation at the last minute to fly to London instead – not a decision I regret, but nonetheless…
As far as I can tell, residents drown in the MICU with work weeks totaling over 100 hours, far too many admissions of critically ill patients, and minimal rewards. It is here that families suffer, that patients pass away, that all the lines and tubes of medicine are utilized to their maximum in heroic attempts to save lives, at hundreds of thousands of dollars a day. This is the superior, high-level care which epitomizes the American medical system. Any invasive measure, at any cost, to save a life. This is the unit in the hospital where people do not ask three important questions:
What is quality of life? Why are we prolonging life? What is a death with dignity, and can it ever happen in this country?
Rather than addressing these questions, we build these MICUs and perfect our medical skills and enhance our medical knowledge, to the point where we can no longer recognize what is beneficial and what is detrimental to the patient and their family.