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by jbandela1 759 days ago
> When told of my upcoming case, I had mixed feelings. On the one hand, being in perfect health, unaccustomed to suffering and therefore easily disconcerted by the thought of death, I was horrified. My attitude toward death was like that of a young person standing blindfolded and tied to a post, awaiting a volley from a firing squad. The whole concept made my blood run cold. Yet the case also aroused in me a feeling of relief. Simply put, there was no risk of malpractice, as my patient was already dead. Many anaesthesiologists have such self-centred thoughts when taking care of ASA 6 patients.

> After we moved her from the gurney to the operating table, the doctors and nurses, so used to taking care of living patients, stared at one another stupidly, as if not knowing why they had come together or why they stood around the table.

Sorry this strikes me as embellishing for the case of writing a story.

Background: I was a neurosurgery resident at a level 1 trauma center. I was involved in determining brain death (though the final certification was by an attending surgeon). I worked closely with the transplant team. I declared (normal) cardiac death many times. I had many agonizing conversations with families about withdrawal of care.

Anesthesia is a 4 year residency. Even the 2nd year anesthesia residents I worked with had more of an awareness and lack of naivety that this author shows.

And the OR teams were much more prepared and professional than this. They knew what they had to do and why they had to do it.

If there are other physicians here, I would love to hear your opinions, but this whole piece strikes me as overwrought and full of embellishments to make a certain point.

5 comments

Yes I agree with you. This doesn’t add up to me. Especially this part:

“On the one hand, being in perfect health, unaccustomed to suffering and therefore easily disconcerted by the thought of death, I was horrified.”

When one is a medical student starting anatomy working on cadavers I remember such thoughts being common. But by the time one had gone through years of medical school and then years of residency I would be quite astounded that one would still have such a reaction.

It seems different if the person is a living cadaver, especially one without outside indication that they are dead.

I could see that affecting someone differently.

I work near health environment, and what I notice is a heavy selection. If someone doesn't tolerate "living cadavers" they quickly take options: go to the private sector, take a speciality that doesn't deal with such events, or in the worst cases they drop out to something like the pharma industry.
Yeah in my case electrical engineering :)
Agree. Also an MD.

My own personal experience with deceased donor transplantation is the pre-donor screening imaging to make sure there’s not a surprise cancer hiding for the recipient…

This had the flavor of being written by one of those types who’d rather write breathless blog posts about taking care of patients than actually taking care of them.

If you’ve been to medical school, you know the type.

Not a doctor, but I did grunt work in a pathology lab to pay through undergrad. > the doctors and nurses, so used to taking care of living patients, stared at one another stupidly, as if not knowing why they had come together or why they stood around the table. For a brief moment, each one of us likely had the same supernatural vision, how for the past six hours, after being declared brain dead, this woman had lain under the measureless power of death. Six hours she had been officially dead. Six times had the hour hand on the clock moved – and she had lain dead. Now she had re-entered the world of the living.

I saw that reaction to death exactly two times during morgue drop offs: once from a younger L&D nurse—although I think it was more the inside of the morgue walk-in creeping her out—and once from an ER nurse with a 9 year old (asthma attack). Never from any doctor, although granted I almost never saw any doctors at all at that shitty community hospital. I don’t think it really stops being weird, I think it’s baked into our brains just like arachnophobia in some people, but I’d be concerned if an OR team, let alone a transplant team, were sitting around in silence like that. Usually they listen to the radio.

It’s fairly common for people to be paid by special interest groups and lobbyists to put their names on ghostwritten articles. It’s what got Amber Heard in trouble. I could see it happening to doctors.

I agree. It seems very indulgent to say the least.
aeon, atlantic, the new yorker. What would you expect from any of those august organs of the press?
Overall high quality content, of a certain flavor?
> of a certain flavor?

Yup, creative writing.

Thats what most journalists do these days. I was even told straight to my face that "creative writing" was necessary as the mediaoutlet already knows what their readers like, and therefore facricate paragraphs which they know will be well received. Facts are unwanted, especially if they lead to complicated explanations. JOurnalisms is dead. Its only kept alive by the false claim that it (not in its current state) is necessary to keep democracy alive, which is also a self-surving lie at this point.
I’m open to this cynical perspective but what do you think the journalists feel about their profession? Are they simply doing this to survive and earn a living? Or are they aware of its corruption? Or do they somehow think they’re still performing the job of defending democracy? What about people like professors who teach journalism? It’s hard to imagine that everyone is totally corrupt as to not want facts, although I do agree that news outlets have biases…
I am suspecting they are doing this simply to earn a living. Most people do. In the end, income is far more important then morale.
It's likely just a selection process similar to politics. Are you willing to lie, mislead, deceive, and sell yourself to the highest bidder? No, well then good luck beating your opponent who is doing all that, going to have more funding, more widespread appeal, and never a single inconvenient position because his positions on everything are whatever polling tells him the voter wants to hear.

Newspapers (and employers in general) can now do similar filtering, if they want to, thanks to social media. If you're not committed to pushing a desired narrative, and willing to spin anything to fit it, then you're not getting hired. And given the state of society today, it's unclear if a newspaper with objective or diverse reporting would be able to compete against the current batch of confirmation bias delivery services.

Huh, I don't understand your reasoning.

The first half of your comment provides a sufficient reason why something resembling journalism stays alive: readers want these stories.

What does this have to do with democracy, and what's the causal chain that goes from democracy (or the zombie of democracy, I guess) to keeping journalism in suspended animation?

Journalists claim their work is necessary for the democratic process. Which they use as a reason why their work is supposedly important, even though they are not really reporting anymore, just making up things.
Paired with a nice chianti, of course.
“Hyperdecanted” with blender, right?
And some fava beans.
In my hometown, there is a foundation focus on propagating some declaration about Tibet people sacrifice human in their traditional religion. the reference is New Yorker...
hahaha, Why you give me angry vote, this is true that New Yorker offered resources to racism and colonialism.
Not entirely sure what you're getting at here -- what do those other two publications have to do with this essay?
They’re saying that just like elzbardico on Hacker News, those magazines aren’t good at writing.
touché!
At least better editing than this terrible writing:

> Six hours she had been officially dead. Six times had the hour hand on the clock moved – and she had lain dead.

Probably written by AI.