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NYTimes: What Should Doctors Do When We Experience a Miracle?

  • 1.  NYTimes: What Should Doctors Do When We Experience a Miracle?

    Posted 07-03-2021 10:08
    Usually when we talk about cognitive bias or patients and families suffering or outliers, we are referring to errors that cause patients harm because the diagnosis - and therefore the treatment - were wrong or delayed. This article is about when a diagnosis is right but the prognosis is wrong. About when miracles happen. About when doctors use their experience and expertise to inform and prepare families for a patient's death but death does not occur. 

    I knew a patient like this. A woman dying of metastasized cancer who was in a coma. Her son flew halfway around the world to sit at his mother's bedside for two weeks. After two weeks, with no positive or negative change in her status, he flew home thinking that the next call he would get would be to return for a funeral. Instead, the next call he received was to tell him she had woken up from her coma, followed by one telling him all signs of her cancer were gone. It was a miracle, his orthodox father claimed. She lived another 10 years.

    Sharing with you the views of Daniela J. Lamas, a pulmonary and critical-care physician at Brigham and Women's Hospital in Boston, in the New York Times.
    What Should Doctors Do When We Experience a Miracle?

    "Though his story is remarkable, there's a part of me that doesn't want to share it. Not because our predictions as his medical providers were wrong - I am comfortable with admitting to prognostic error - but because most people, when faced with illness, secretly believe that they may be the outlier, that improvement is possible even in the face of overwhelming evidence to the contrary. Doctors want that for our patients as well. That is what leads oncologists to offer terminally ill patients fifth lines of chemotherapy and last-hope clinical trials, and it is what brings surgeons back to the operating room one last time. 

    Sometimes that drive to beat the odds is what pushes doctors to be great. But if taken too far, these instincts lead to false hope and suffering for our patients and their families, protracted critical-care admissions and futile procedures. After all, in most cases in the I.C.U., our initial prognoses are correct. So there's a risk to standing at the bedside, thinking about that one patient who made it home despite our predictions. We can give that experience too much weight in influencing our decisions and recommendations."

    Click the link to read the whole column   https://www.nytimes.com/2021/07/02/opinion/doctor-death-covid-miracle.html?