When Should Dying Patients Stop Treatment? | Being Mortal | FRONTLINE
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- Опубликовано: 13 сен 2024
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Why is it so hard for doctors to speak openly with their terminally ill patients about death as the end nears? Dr. Atul Gawande, Boston surgeon and author of the best selling book "Being Mortal" had a remarkably candid and intimate conversation with the widower of a deceased patient and apologizes for offering false hope in the end.
It's the story of Sara Monopoli who was diagnosed with Stage 4 lung cancer during the 9th month of her pregnancy at the age of 34.
The Monopoli case is one of the key stories that inspired Gawande to explore the big question of what really matters in the end.
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I appreciate the husband being candid about his devastating and unimaginable loss. May he and his daughter find peace they never knew possible.
Both men show such grace...
I have a mestatic melanoma on my brain. Knowing what the odds are for surviving over 2 years, I had directed my very dedication medical team that - when I decide the quality is gone, it's time to stop.
We'd all like to live as long as we possibly can, but there comes a point at which life isn't life. It can turn to existing in a world of constant "close calls," medications that make you feel so sick you're afraid you won't die anytime soon, and it becomes a frantic way of trying to gain just one more day. This is when I think it's time to accept the fact that death is coming, and perhaps it's best to enjoy what time one has, rather than spending your last months of life in agony.
Wait your gonna die in 2 years?
I agree with you. My circumstances are different, but I'm not going to do the "fight" part. I've done that for three decades and I'm exhausted with the fight. There's a point in which death isn't so scary. It's scary to think of living in pain for many more years.
*Thank you for this perspective and may you rest in peace...."David James Seavy, 59, of Rochester, died Wednesday, Feb. 8, 2017, at his home.....Dave was a very compassionate person whose main focus was being a good friend, relative, counselor, and caregiver. His primary concern was others....."*
Dave Seavy try methadon
Wow.... Just read the person who commented this @Dave Seavy Passed away.
May you Rest in Peace.
He sounds like such a compassionate doctor, those are so rare these days..
@harsh savla you need to watch the video again. He explains why he thinks he said that. I don't fault him at all. I have been with both my parents as they died from cancer, and my husband from COPD and CHF. I understand everything that was said here.
He LIED ..to the family ..and didnt give them the last time of quality time together ..how compassionate is that ???
My surgeon was blunt, with all the charm of a rock, but, he was upfront, honest, and told me my choices, and my chances. At first I was angry at his lack of compassion, but as I look back, I appreciated his honesty. Luckily, I beat it, and chose to undergo a full force treatment regime, instead of alternative treatment. I had stage 4 colon cancer, with only a 10% chance of surviving the following few months. He said that not many survive full on chemo and radiation by this point, and that many choose to focus on the remaining time left to settle their affairs, and make the most of it, but told me it was entirely up to me as to how I wanted to proceed, with equal odds on both sides. I was only 21, and an stubborn as hell. I wasn't about to give up, and let it kill me, I decided to fight it down to my last breath. So, we began intensive chemo, and radiation, along with a modified diet to help increase my chances. It was hell on earth, I was miserable, in agony, and almost gave up several times, but he refused to allow me to quit, and told me if I've made it this far, I can and should keep going, so, I did. That was 27 years ago! The cancer literally vanished from one week to the next after months of the therapy, and I walked out of that hospital on my own two feet, and even drive myself home (with my family of course), and I never looked back. I will always have that paranoia it may come back, but now that I know anything is possible, I honestly don't worry about it anymore. So, for future reference, I'm much rather have the cold looking doctor that tells me the brutal, honest truths, then one who gives false hopes and gives up on me. He saved my life, and we've actually become great friends, I thank god for him every day of my life!
TJ Devereaux woW!!! Awesome 😎
Congrats bro, I'm glad you fought!
god bless bro
I am dude so have no idea about labor pains but I know the pain is very bad I do know from exsprrience what a collapsed lung feels like and it's one of the most painful and scary things. you no matter how hard you try you can't take a deep breath at all so you begin to feel like your drowning then add the pain that comes from trying to breath which feels like someone's stabbing you in the chest and the pain goes all the way to you your back and neck. so for that mother to deliver her baby with a collapsed lung is unbelievable and it's almost hard to believe someone can take that much pain at one time like she did from labor and delivery to a collapsed lung without passing out. just a true hero mother.
fact topia I didn't even realised this. Thank you for pointing that out. I experienced labor. I cannot imagine being so sick at that moment.
A hero mother indeed!
Life is so short. People think that cancer comes with a death sentence but in reality, EVERY life comes with a death sentence. For saje of argument the husband could have a heart attack and died before his wife did. We need to live our lives knowing that our clocks are ticking and could stop any minute.
My husband had a heart transplant. He used a ventricular pump for a year until he received a heart. What they don’t tell you about heart transplants is that you will have to take about 30 pills a day and inject yourself with insulin, and as a result, you’ll die from “Renal Failure.” My husband existed for about 8 years and died at age 64 with the stamina of a 98-year-old man. His father lived an extra year without going to any doctor. Heart transplants are a money-making business just like sex transplants and liposuction, etc. My husband’s insurance covered over a million dollars in treatments.
Most appalling is the treatment he received in the hospital that listed him as terminal. His shoulder bled from needle catheters for 3 days because his platelets weren’t clotting and had nose bleeds for hours and was left to bleed. When transferred to the ICU, he was placed on a 24-hour dialysis machine that shut off within the first five minutes for about eight times consecutively, but they kept scheduling the failing treatments, and he had to have several blood transfusions. Despite this, the doctors reported that his statistical numbers had improved. He was continuously tested, medicated, pronged as teams of doctors and personnel made their morning rounds to claim interest to his insurance money.
My husband was cognitive; yet, his body was washed and rubbed down like a stable horse by nurses who just saw him as a job like his doctors. He never saw his cardiologist who was in the doctor’s lounge, three doors down although he asked for him daily.
He was not in respiratory distress and was breathing on his own and his lungs were clear, but the doctors installed a ventilator hose down his throat whose diameter was as large as a baseball. Later, I researched and discovered that an endotracheal tube taped to the corner of the mouth was supposed to be used and only the ventilator hose was used for brain damaged patients.
Afterwards, I was so distressed by the inhumane treatment of my husband that I went to a lawyer. “The law is that hospitals can not be sued for patient care if the patient is listed as terminal.” We took him home where he wanted to be although the doctos said that he would die on the way home. He lived for six days at home, and died peacefully in his sleep, in his own bed, with his family around him.
Victoria Matthews the hospital continued with treatments so they can collect insurance money. Just terrible. Sorry for your loss.
This Dr is outstanding. His level of humanity and compassion is something I've rarely seen in the medical community.
this makes me feel so much better about my husband's decision not to do chemo or radiation. Thank you.
At least she had a loving husband who teared for her, cared for her till the end, and stood by her throughout her pregnancy. At least, she had her family and was not alone.
Worth the time to watch and ponder lifes meaning at the end of the day.
I'm one of the 5 who survived cancer. I was only 31 and my 1st yr teaching high school biology and chemistry. My doctor never told me I would probably die. After yr 5 of surgery, he then told me I was his miracle patient. I only took 3 wks of radiation vs 5; I felt that the radiation was killing me, so I stopped.
I eventually earned a doctorate degree and live everyday like it is my last day. I am 68.
Feb 21, 2020.
what a strong women...imagine holding that baby and knowing that she would not be around to see her grow up...goddamn like is so incredibly unfair...
The comments on cancer related videos are some of the saddest things. I'm normally not phased by death and whatever but when you see these peoples comments praying that their treatment works for their cancer... and then you realize that it was posted 3 years ago...
I'm right at that point now. I'm supposed to start chemo/radiation on May 24/2019. I'm not even sure I want to. I have anaplastic thyroid cancer, and it's already been seven months. Six weeks of treatments seems almost pointless, but the doctors recommend it. But why delay what we know is inevitable? It's a tough choice.
@@eltonjohn3236 bro are you alive please reply.
Shivansh Agnihotri he dead
@@eltonjohn3236 Elton, I don't know if you're still here, but, Stay Strong!❤️
Fazed
My grandma died from lung cancer a year before I was born. I wish I could’ve met her. My mom calls me her “miracle baby” because I was born almost exactly a year before her mom died. I’m scared my mom might get lung cancer and have the same fate as her mom too because my mom has been smoking since she was in her 20s and is 50 now...
The highlight of the whole thing is, everyone wants to be the one on whom it might magically work ……. For us as providers it is important to let every patient talk their mind …… and be vulnerable with the patient and let them know that “ we surely don’t know everything,”
I wish my mom had had a doctor like this guy when she was going thru her battle with peritoneal cancer. She passed away a little over a month ago, and I didn't even know she had stage 4 primary peritoneal cancer until the day before she died. She didn't have health insurance and had no money, so she couldn't go to a doctor when her symptoms first started. She finally had to go to the emergency room bc her stomach swelled up really big and she was in pain that was unbearable. They did some tests and came back and told her that she had fluid in her belly that was called " malignant acsites", and it was an end stage complication of several different kinds of cancer. She was admitted and they did do tests there and found out she had peritoneal cancer that had spread to her liver, lungs, kidneys, and colon. She didn't even call me to tell me bc she said she didn't want to upset me. I found out she was in the hospital and I rushed to see her, not knowing what I was getting ready to walk into. I walked in her room, and the second I saw her, I knew she was dying. She looked like a 8 months pregnant skeleton. It felt like someone had punched a hole in my chest. She was so out of it that she couldn't tell me what was wrong, so I talked to her doctor and a nurse, and they coldly told me " she has stage 4 primary peritoneal cancer, and it has metastasized to other organs, far away from the primary tumor site. I asked him if she was dying and he said " I don't think we are there yet, but everybody will die one day!" My mom went into cardiac arrest that night and my younger brother and I had to take her off life support. She died within the hour after that. The doctor came to me after that and said they think she may have overdosed on some kind of narcotic and that's what caused her cardiac arrest. My mom was only taking the narcotics that the hospital was giving her for palliative care. I demanded an autopsy be done but they refused and said if I wanted one, I would have to pay for it myself and I have no money, and it just wasn't possible. It's been over a month and her cause of death is still " pending". I just don't understand why doctors can't be honest with ppl and be caring and understanding. The worst experience of my life.
Hey Andera, I don't know how terrifying the life could be after the person who gave you birth, the person who you grow up with, the person you have the strongest bond with is no longer with you, I hope that now you have stabilised you life a bit, Stay Strong.
Damn Sweetheart I’m so so sorry you had to go through losing your mother first of all, and then in such an horrific way. I wish for you peace and comfort in the memories you have of your mom. I am reeling in this pain as I have just lost mine this past year as well. Much love to you.
The doctors probably gave her the palliative sedation. They give it to most patients at the end and hours away from dying. They be suffering with pain. No cure just let them go with the Lord.
5 years ago, my dad was diagnosed with kidney cancer and had to have his kidney taken out. A year later, the doctors found out the cancer metastasized into his lung. He's reaching the 5 year mark of when the cancer was discovered. Within those few years, there has been no other song of cancer. The odds of that happening were less than 20%
I hope he's well now!
you should interview hospice workers they openly talk about the experience of dealing and accepting death doctors never really spend time with dying patients they get frustrated because they can't fix it or want to deal with it. American med schools should force doctors to be to do six months of home care hospice work one on one to see and learn from the vast experiences they can gain from the opportunity to do one on one care for terminally ill
So sorry for the poor husband. Hard to see him still suffering. Maybe, knowing stage 4 was so deadly, " treatments " could have been declined and quality of life would have been greater for these few months she had. Speculation now. I know I would refuse any treatment if I were diagnosed with such dead end, but I am not a young mother. That complicates everything. In terms of the thyroid cancer, it is rarely a big deal....certainly the lung cancer was the problem. So tragic and bizarre to see young people dying of stage 4 lung cancer. That is a radical new !
Every, every doctor should read Atul's books. Think practically about patients, don't go down the same old road(s) try new things outside the norm. Other chances may be far better chances. Creative risk mitigation in medicine has broken down old pathos in medicine. I've paid $800 an hour for doctors only to sit and listen to themselves talk. They have convinced themselves they are savors. My daughter had whooping cough. He sat there and he went on an hour long asthma diatribe and it was: WHOOPING COUGH dummy!!! Jesus.
3:07 What is that touch up the video editor did to Atul near the bottom of his neck?
One thing that I will always remember about cancer is that, "Cancer kills you faster if your mind is not strong".
My mom called and told me while crying that she was diagnosed with Endometrial Cancer.
She was severely depressed by it that she was like 24/7 crying.
I got really mad at her and guess what, I scolded her like there was no tomorrow.
It was the first time I got angry to my Mom.
I told her that Cancer won't kill you, but depression does!
And then I told her that the first step of healing is acceptance.
It's already there, so let's do something about it.
We went to the hospital and have the tumour removed.
She's cancer free now.
Sara and her husband were so brave and they had a doctor who was an absolute pleasure to listen to . His compassion is so rare these days and hats off to Sara's husband for being able to talk about this. This is why 'advanced care plans' are becoming so vitally important. My beloved partner died of lung cancer and we both knew when the time had come to say our farewells, tell each other how much we loved and adored and would miss one another and the final thank you for the outstanding 47 years we spent together. Advanced care plans allow this so there are no regrets when it is too late to communicate.
This is absolutely beautiful.
what an amazing insight into the time at the end of life, a brilliant doctor reflecting on how invested he had become in saving a patient, and her husband wanting to do everything to sustain life...i don't believe there are right or wrong answers, you can only do your best at any given time
My God, a young woman going through birth with only one lung! I was healthy, and I had an extremely difficult time. It seems so unfair that she couldn't even hold her daughter. I know what cancer is and how it manifests in the body, but I don't understand WHY it happens, and why is it so difficult to find a cure.
it is very complicated...how we get it, what type....and what " treatments" are offered. It has to do with many toxic materials in our environment, evidently . " Treatments" are more of the same as big pharma is not really keen on spending $$$ on new R+D. They like to play with the cocktails different oncologists use.....Nothing radically new. When someone comes forward with a revolutionary method to treat a cancer, they usually get pushed away and treated as the plague. Pharma is too big to deal with. That is where we really are. One form of treatments for all....forgetting every human and every cancer is different. We need major changes. Maybe they will come. One Chinese American research scientist is working on it. I hope he survives the swim upstream.
Thank you, lina Nicolia. I've had three friends die of cancer, and one is in treatment now. I know there are many different types of cancer, but my very unscientific description if it, is an unwanted, foreign,mutated and toxic "thing" that robs people of life and their families of their loved oned. It breaks my heart.
BTW, I pray that the research scientist is successful.
The ideea of cancer os that some of your somatic cells startto multiplu by their own,when they shouldn't be. rmTreating cancer is so difficult because your body sees the mutated cells as yours,so their attack mode is not triggered. If cancer is belign,it's not so bad,because if you remove the diseased cells it won't come back. If it's malign,the mutated cells will go and reproduce through the entire body and you can't stop it :(
Cherish Life, everyday is a blessing
Thank you. I have Stage 4A Ductal Prostate Cancer. For now the drugs (after surgery and radiation) are doing their job. Unfortunately they are also doing a job on me. I had some god results from my last bloodwork and scans (but not perfect). I am going to ask for a temporary “vacation” from treatment so that I can feel human again. Eventually (hopefully a long way away) the cancer will finally win. At that time I want to be able to spend it with my wife and not in the ICU. May God bless all cancer warriors.
If i were to have a terrible terminal illness, I think I'd want to only prolong treatment until A) there's medically no hope of recovery and the treatment is just buying me a few more weeks/months and B) the treatment is only prolonging my life for those few weeks/months but not giving any quality to it. When that time comes, it's the humane choice to give people.
Can’t believe the trolling this guys parents pulled by naming him Rich Monopoli
I think sometimes the treatment out weights the outcome. let people have a good death
So many chase life, like they are going to live forever.
Cause people are scared of their mortality
Frontline Vice only wishes they could do it like this. True investigative journalism.
indian doctors are one of the best doctors in the world and their own countrymen don't appreciate them.
Well there are a few people who have been diagnosed with stage 4 lung cancer and are long term survivors (5 years or more).
Most of them are rather young in good general health and have never smoked, so the cancer they have is a special kind of tumor.
"Mandated cure rate....," -- what does that mean" Is there a plan, a rule, an authority or vast conspiracy that requires exactly a 2%. cure rate? It may be more complex, more complex and not so cynical then that. .
If the doctors of Two generations back had thought exactly the way you thought of not fighting death till the last breath, I doubt we would have come where we are now...and this fight shall take us to more advanced medical treatment..we need to make constant efforts to excell..it will cost some painful lives now, but the medical treatment will get improved...what say ?
This is tough, man..
It's up to them. Let them decide....the treatments are only extension of their pain and misery. They need the statistics.
Most do not decide purely based on statistics. Often one's emotions look for a reason not to believe what would be evident by the numbers..Statistics are mostly averages. Do you live based on the average or norm? If so when your time comes to die it, there should not be any complications
2% "healed" is not in his book, he has to "miracle" all the new "medicine", to string out the patients insurance or medicare for the Tesla this year. Stopping treatment means the last month, not the last year.
I saw this on Frontline, Rory Feek went to Washington to sit at the roundtable to be able to fight with dignity.
At 3:06 the editor must've been in tears or something, look at his chest. They should've just left the microphone in view, why edit it out?
It kills the mood.
Doctors would never have to do this as much if they would only make sure that nutrition was the medicine. The lack of compassion that is not really shown, hiding behind a veil of medical practices that have a low cure rate and an insurance policy paying the bill breaking the back of the nation with debates on even getting health care to the citizens as a whole. Conservatives, praying religiously, want to cancel health care for millions and the AMA will not show understanding, that they do understand, about the power of organics and herbs. They purposely reject it without moral responsibility to give the tests for developing diseases and then prescribe a synthesis of herbal metabolic action that does not absorb into an organism and leaves junk in the cells and uses sugars to penetrate cells that crystallize in the fluid like a viral infection they call side effects.They go as far as to supplement the diet after appetite is suppressed from pills and radiation, with drinks that have high amounts of artificial sugars that are crystallized in Ensure and Boost intensifying sugar to 200-400 times sweeter and have no nutritional value.
should money be taken into account?