Thursday, August 20, 2009

On Death & Dying (by res ipsa loquitur)

Did you read this story about how doctors tell their patients that they are going to die? A few rambling thoughts ....

But first, some background. When my mother was diagnosed with breast cancer in the 1960s, her doctor told my father that it would kill her. That prognosis was deliberately withheld from her by both of them, but my mother was aware of her own body and the people around her. She knew something (bad) was afoot and the anxiety, frustration, and anger attendant in that knowledge informed every aspect of her -- and our -- existence. Eleven years later, when the cancer recurred, she was told that yes -- it would kill her, and relatively soon. This time, she withheld the prognosis: from her children. To state the obvious: it is extremely difficult to discuss death. Would it have been any easier if my father had been given the diagnosis?

So the feminist angle to this article ... What are the differences in what news doctors deliver and the way they deliver it -- to men vs. women today? Unfortunately, we only see one "patient" in the role-playing exercise: a female. If there are differences, are they informed by gender? Or social class? Wealth? Or age? Or whether the woman is a mother or childless? Look at the picture in the article: the five people accompanying the doctor are all female. What happens when doctor and patient are female? Do male nurses, social workers, counselers ever accompany the doctor? Watch the video accompanying the article. I bought what I consider some sexist assumptions to the table in assessing the performance of the residents. The female? Too clinical. Too dispassionate. The male? Unable to close the door on all treatment/hope. I'm sure they'll both get better at this. Maybe I will, too.

(I wonder if they role-play a patient who just gets furious at the terminal prognosis? I suspect that's what I'd do.)

Anyway: discuss.