EagleTribune.com, North Andover, MA

April 14, 2013

Column: When caring must take the place of curing

Dr. George D. LeMaitre
The Eagle-Tribune

---- — Let me state at the outset that I am irrevocably opposed to mercy killing, active euthanasia, physician-assisted suicide or any other fancy name you want to give the taking of a human life.

Having said that, I want to flip the coin and express my grief at my profession’s obsession with keeping life going when it is time to say goodbye. I have seen this over three decades of my practice and it gets no better with time. Indeed, as the ability to cure increases, the desire to use those powers grows increasingly bizarre.

Walk into any nursing home. There you will find a range of human beings in the advanced years of their lives. Many are comfortable, enjoying their final days, weeks or years and it is a wonderful place to be when the family can no longer bear the burden of maintaining their loved ones at home.

But there are also, in those homes, people who no longer function as humans. They have lost all connection with life as we know it and yet, check the catalogue of pills they are taking: pills for their hearts, their kidneys, their blood, their liver. Check the number of times they are given antibiotics to beat off life-threatening infections, the number of transfusions they get when their blood levels drop. Check the number of times they are shipped, at all hours of the day or night, to our hospital emergency rooms to receive yet another dose of modern, high-tech medicine or surgery in an effort to keep these poor souls alive.

Not too many years ago an elderly friend of mine, in the last stage of Alzheimer’s disease, was rushed to the hospital emergency room with a urinary tract infection. This was due to an obstructing prostate gland and unless an operation was performed to remove the obstruction, he would surely die. I was away at the time and had no chance to intervene or advise the family. As sure as sure can happen, and the surgeon is there with his tools and his skills, he underwent the prostate surgery and is back at the nursing home in perfect physical health, unaware of who he is, where he is or what it all means.

Physicians, especially but not exclusively oncologists who treat cancer, have a technological imperative, an obsession to apply their skills and their techniques to try curing disease. Often this imperative gets beyond reality and they treat people who ought to be left alone and kept peaceful and comfortable in their last days.

There is a place and a time in each human life where caring must take the place of curing and the time, effort and, yes, money ought to be spent on comfort, not organ-sustaining pills. When I reach those last stages, I want my health care proxy to bring friends and family to my side, not doctors and surgeons. I want my proxy to run through my list of pills and challenge the doctor on each of them. When the pill is designed for my comfort, go for it; when it is a mindless attempt to keep my organs alive when it is time for me to leave, stop it. I don’t want heart pills; I want heart.

My final plea to my doctors, who are welcome as friends at my bedside:

“Doctor, don’t just do something, stand there.”

George D. LeMaitre, M.D., an Andover resident, is a vascular surgeon and founder of LeMaitre Vascular Inc., an international medical device company.