Medical training prepares us to react to acute illness. We learn to use technology to do something, expecting to cure, snatch people from the jaws of death, and restore their health. This has made many people think we’re superheroes. Sometimes we find ourselves buying into that adulation, then we wait for the next acute episode, poised to use more technology, but most of us are at a loss when our capes become tangled in the cycle of chronic conditions.
Today, the challenge of American health care is chronic illness, for which there is no known cure. The goal of chronic disease management is to keep people as independent and as comfortable as possible. We strive to avoid acute flares, and the hospitalizations that often follow, because technology isn’t the always the answer. When chronic illness takes its inevitable path to the end of life, the goal is a comfortable, dignified death. Yet, all too many of us in medicine have allowed technology to put blinders on us. We see success only in terms of cure, view death as failure, and frequently insist on using technology far beyond its utility. The last thing health care practitioners should be doing as chronically ill patients are transitioning out of this life, is leave them feeling more wounded.
The practice of medicine involves cutting-edge science AND sound clinical judgment. When we do something without considering the long term implications for the patient, we fail the patient. Instead of just focusing on diagnoses, we need to individualize therapy, making sure that our actions improve function, comfort, and quality of life for that specific patient. Once we accept that CARE is as valuable and as prestigious as CURE, we’ll be able to stop using technology when it becomes an instrument of harm. We’ll realize that when we just STAND THERE, we’re still engaged in important activity. Offering comfort and being present is heroic, too.