Hitting a Nerve

Diagnosing death in your fellow physician


 

"By medicine life may be prolong’d, yet death will seize the doctor too"

–William Shakespeare, in "Cymbeline"

Recently, I had the unpleasant job of diagnosing another physician with amyotrophic lateral sclerosis. It hit home hard, as he and I have referred patients back and forth for years, and we are at similar stages in our lives and careers. I genuinely like him, both as a person and a doctor.

This is unquestionably the most horrible disease we deal with. Its impact is such that, regardless of specialty, all doctors from medical school onward know what those three letters mean.

It’s tragic for anyone, but seems particularly awful when it happens to a fellow physician.

Why is this? I’d venture that there’s a mysterious, unspoken belief that, because we (physicians in general) devote ourselves to helping others, we should be magically immune to the same disorders. I’m not saying this makes sense, but I suspect there’s a remote sense of denial. Like the witch doctors we started out as, the evil spirits we protect others from shouldn’t be able to harm us.

There’s also the tragedy of a life cut short, especially when it’s one lived to serve others. After all the years we spend in training, it seems even worse to see it all end so soon.

I’d argue that there’s also a fear of the unknown. We all hope to avoid another’s tragedy by not doing something risky, like smoking, skydiving, or not wearing a bike helmet. In this respect, I think ALS becomes particularly frightening because there is (with current knowledge) no particular risk factor you can avoid to try and prevent it. The random chance of purely horrible luck is terrifying. No one can say, "Since I don’t do (whatever), it won’t happen to me."

For those of us not directly affected by the tragedy, it still reminds us of our own mortality and how random acts of fate can change our lives so quickly.

Good luck, my friend.

Dr. Block has a solo neurology practice in Scottsdale, Ariz.

Recommended Reading

Duloxetine reduces chemo-induced neuropathy
MDedge Neurology
Dementia costs top cancer, heart disease
MDedge Neurology
Survey shows mixed AED safety knowledge among neurologists
MDedge Neurology
Low weight may contribute to risk for natalizumab-induced PML
MDedge Neurology
Reports indicate dalfampridine may worsen trigeminal neuralgia
MDedge Neurology
Early surgical menopause linked to cognitive decline
MDedge Neurology
FDG-PET strongest independent predictor of Alzheimer's dementia in MCI
MDedge Neurology
Money Troubles: The Policy & Practice Podcast
MDedge Neurology
Measuring the true costs of an EHR
MDedge Neurology
Feds bolster efforts to understand the human brain
MDedge Neurology