by Brian Carty, MD, MSPH

Medicine is often about helping people live with impairment.  Even normal aging is about living with an increasing number of limitations.  We don’t welcome them, but life gives them to us anyway.  According to Ecclesiastes 9:11-12, we all eventually become victims of time and chance:

For man also knoweth not his time; as the fishes that are taken in an evil net, and as the birds that are caught in the snare, even so are the sons of men snared in an evil time, when it falleth suddenly upon them.

But life is precious and people cling to it.  Even those with a terminal disease do not wish for death or want to hasten it, despite popular misconceptions about assisted and “rational” suicide.

In “Reflections on Doctors,”  a book of essays written by nurses, one of the essays - “A Physician’s Definition of Failure,” deals with the meaning of medical failure.  The author, a nurse, worked in a rehabilitation unit for patients with brain and spinal cord injuries.  One of her patients, paralyzed and confined to a wheelchair, was once a high school basketball player.

His high school varsity basketball team photo was hung in his room.  One day when the nurse and the medical director, a neurosurgeon, made rounds, she showed the doctor the picture.  When he saw the photo, the medical director became very upset.  Seeing the picture made the medical director feel as if he had failed the patient; he couldn’t “fix” him, restore him to his former state - the basketball player in the photo.

The nurse was shocked.  She says that “had it not been for this doctor’s skill, talent, and vision of rehabilitation, this young man would not have the future he had in front of him.  He would finish high school, go to college, get married, build a successful career, and have children.”

Many people who accomplish much less than this can’t necessarily be considered failures.  Doctors, nurses, and other medical professionals learn early in their careers that many of their patients will never function normally.  However, that shouldn’t stop medical people and their patients from getting on with life.


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