Knowing How Doctors Die Can Change End-Of-Life Discussions : Shots - Health News Dr. Ken Murray wrote an essay a decade ago about how the gentler care doctors choose at the end of life stands apart. His work still shapes how some doctors talk to patients about death.
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Knowing How Doctors Die Can Change End-Of-Life Discussions

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Knowing How Doctors Die Can Change End-Of-Life Discussions

Knowing How Doctors Die Can Change End-Of-Life Discussions

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ROBERT SIEGEL, HOST:

Doctors don't face death like the rest of us. More of them die at home with less aggressive care at the end of their lives, but very few doctors report having conversations about death with their patients. Well, there are signs that that is slowly changing. Stephanie O'Neill, of member station KPCC, brings us this report.

STEPHANIE O'NEILL: Dr. Kendra Gorlitsky recalls the anguish she felt performing CPR on elderly, terminally ill patients, which looks nothing like what we see on TV. In real life, ribs often break and few survive the ordeal.

KENDRA GORLITSKY: I felt like I was beating up people at the end of their life.

O'NEILL: Gorlitsky, who now teaches medicine at the University of Southern California, says these early clinical experiences have stayed with her.

GORLITSKY: I would be doing the CPR with tears coming down sometimes and saying I'm sorry, I'm sorry, goodbye, because I knew that it was very likely not to be successful. It just seemed a terrible way to end someone's life.

O'NEILL: Gorlitsky wants something different for herself and for her loved ones, and most other doctors do, too. A Stanford University Medical School study shows almost 90 percent of doctors would not want resuscitation and aggressive treatment if facing a terminal illness. It's data that support an observation Los Angeles doctor Ken Murray first made about 10 years ago after the death of a colleague.

KEN MURRAY: He had died at home. And it occurred to me that I couldn't remember any of our colleagues who had actually died in the hospital. And that struck me as quite odd because I know that most people do die in hospitals.

O'NEILL: Murray then began talking about it with other doctors.

MURRAY: And I said, you know, had you noticed this phenomenon? And they thought about it and they said, you know, you're right.

O'NEILL: In 2011, Murray shared his observations in an online article that quickly went viral. In that essay, entitled "How Doctors Die," the retired family practice physician told the world that doctors don't typically die like the rest of us, and he doesn't plan to either.

MURRAY: I fit with the vast majority of physicians that want to have a gentle death and don't want extraordinary measures taken when they have no meaning.

O'NEILL: A majority of seniors nationwide report feeling the same way, yet they often die in intensive care. So why the disconnect? One reason, says Dr. Babak Goldman, is too few doctors are trained to talk about death with patients.

BABAK GOLDMAN: We're trained to prolong life.

O'NEILL: Goldman is a palliative care specialist at Providence Saint Joseph's Medical Center in Burbank, Calif.

GOLDMAN: It's hard for us to say we failed or to let a family down. I think it's - sometimes it's easier to give hope than to give reality.

O'NEILL: Goldman, now 35, read Ken Murray's essay as part of his med school residency back in 2012. He says he, too, would prefer to die without heroic measures, and he believes that knowing how doctors die is important for patients.

GOLDMAN: If they know that this is what we would want for ourselves and for our own families, that goes a long way.

O'NEILL: Nora Zamichow wishes she had read Murray's essay sooner. The LA freelance writer says she and her husband, Mark Saylor, likely would have made different decisions for Saylor's brain tumor treatment if they had. Zamichow says that an arduous regimen of chemo and radiation left her 58-year-old husband unable to walk and ultimately bedridden in his final weeks.

NORA ZAMICHOW: At no point did any doctor say to us, you know, what about not treating?

O'NEILL: In hospice, Zamichow read Murray's essay, which made her realize less treatment might have offered her husband more quality of life in his final days.

ZAMICHOW: What Ken's article spelled out for me was - wait a minute, you know, we did not get the full range of options.

O'NEILL: But knowing how much medical intervention at the end of life is most appropriate for a particular person requires wide-ranging conversations about death that Dr. Ken Murray hopes his essay will continue to spark. For NPR News, I'm Stephanie O'Neill in Los Angeles.

SIEGEL: And that story is part of a reporting partnership of NPR, KPCC and Kaiser Health News.

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