3 of ten males and 2.7 of ten females will suffer a critical illness before age 65. As our baby-boomers come of age this then represents a paradigm shift in health care delivery in this country. We expect to see huge numbers entering intensive care units in the next two decades, something as a physician specializing in critical illness gives me great pause. It does so not just because of the strain it will place on our resources but the focus it puts on the limitations of critical care medicine itself.
There is no conquering of disease in critical illness. About the best we can do is promote health - allow the body time to heal itself - and even that we do poorly. Critical illness is in large part an iatrogenic disorder - almost everything we do causing complication and at least some degree of harm in these very fragile patients. This should give pause and insight into the crudeness of our tools and humble - deeply humble.
Until the day arrives where our tools match the complexity of human pathophysiology and can actually heal we simply must remember how crude our tools and our ability to heal really are. We must always remember we possess the ability to cause harm, to prolong suffering and the dying process. We are not here to conquer disease, conquer pain, conquer suffering - we are here - with humility and respect for our limitations - to promote health and limit harm. We should do so with all our effort when appropriate. But we should also always know there will be times where that will not be enough and to recognize when it is time to stop.
No comments:
Post a Comment