Patients Like Me

I attended a Disease Management Conference at the end of last week as part of my new job. I had expected to be horrifically bored, but was instead exposed to some really wonderful updates and ideas that I would not have known if I hadn't made this switch.
One of the highlights was a speaker from Canada, Dr Alex Jadad.
I heard him speak twice, and took away two things. The first is www.patientslikeme.com. Dr Jadad spoke about how patients are empowering themselves over the internet, and how the medical profession must keep up, or lose out to the advances in technology that are passing us by. I checked out the website and am very impressed by the easy and comprehensive format, which allows the patient to enter and chart his/her progress, and also to print out a summary for the medical professional. The advantages to patients involving themselves in their care, in monitoring and in actively seeking information are almost unquantifiable.
The second session was about end-of-life care. This is a topic that really resonates with me both on a professional and a personal level. Having a loved one deteriorate in front of your eyes, slowly and painfully, is one of the sad facts of our aging population, and something that no one can adequately prepare for. How to we strike a balance between wanting to ensure the best for the person and yet respecting his autonomy, sometimes despite his apparent incompetence? Professionally, where to draw the line in resuscitative or life-support measures in the critically ill was a topic that I had a great deal of interest in from the start. Over the years however, intimate experiences with my patients and their families just made it too painful for me to watch people go through such a heart-wrenching time. I found it difficult not to bring my own emotions into it, and took the sadness and despair home. It would have been wonderful to be able to leave those feelings at work, but I have accepted that that is not the person I am, and this is not the help I can provide my patients. I will find another way to be there for them. Dr Jadad has an interesting approach to this. He doesn't leave those issues at work. He brings them home and embraces them as a human being. This takes immeasurable courage and dedication. I don't think I'm ready for that, but it is inspiring to see someone with that degree of conviction. And the results speak for themselves.
The other idea I left the conference with, tying in to the second point, is when to recognise that we have done our best, and that the patient is going to die. Our responsibility is then to facilitate this (I don't mean euthanasia) with as much dignity as possible, and with recognition that when the patient passes, his loved ones will need care and support. In summary - if death will not be a surprise, perhaps it's time to let nature take it's course.