Tuesday, March 29, 2005

On Pain and Death

A friend turned me on to the blog No Milk Please. Hilarious. I wish I could write as wittily as the author.

So coming upon the following quote makes me feel that I can actually improve as a writer, despite all the edits on the latest draft of an article:

There have now been many studies of elite performers -- concert violinists, chess grand masters, professional ice-skaters, mathematicians, and so forth -- and the biggest difference researchers find between them and lesser performers is the amount of deliberate practice they've accumulated. Indeed, the most important talent may be the talent for practice itself. K. Anders Ericsson, a cognitive psychologist and an expert on performance, notes that the most important role that innate factors play may be in a person's willingness to engage in sustained training. He has found, for example, that top performers dislike practicing just as much as others do. (That's why, for example, athletes and musicians usually quit practicing when they retire.) But, more than others, they have the will to keep at it anyway.
--Atul Gawande, "The Learning Curve," The New Yorker, Jan. 28, 2002
In addition to writing for the New Yorker, Gawande has a book out called Complications: A Surgeon's Notes on an Imperfect Science. I haven't read it yet, but from what I've read in the New Yorker, Gawande is an excellent writer. He really makes the field of medicine accessible to lay readers.

[Later in the day]

Was listening to the Brian Lehrer Show today and heard the tail end of a discussion on "whether doctors work for profit or for the benefit of their patients." Apparently an article by Gawande in this week's New Yorker prompted the discussion. So that might be worth checking out.

And then on the Leonard Lopate Show, Garret Keizer spoke about issues surrounding the Terri Schiavo case. He made really good points, which I'll try to post here later. But Keizer's article, "Life Everlasting," published in the Feb. 2005 issue of Harper's magazine, can be read here. In the article, he makes such points as the following:

  • "But the alarms raised in America’s ongoing right-to-die debate have always been characterized by a curious selectivity. You will notice, for example, how the fear of playing God operates exclusively on one side of the medical playground. Thus to help a patient end his or her life 'prematurely' is playing God, while extending it in ways and under conditions that no God lacking horns and a cloven hoof could ever have intended is the mandate of 'our Judeo-Christian heritage' and the Hippocratic oath."
  • "The right talks about protecting life and tradition, but on some level ... it is mostly interested in protecting pain. For two reasons. The first is theological: the belief that pain holds the meaning of life. Supposedly, and demonstrably, this is a Christian idea. ... The second reason, which can always be counted on to exploit the first, is political: the belief that pain is fundamental to justice"
  • "What I find especially interesting is the way in which the cold-blooded calculation that launches an invasion in which thousands of children suffer and die is imaginatively transferred to decisions seldom undertaken without struggle and seldom concluded without remorse. The woman who deliberates, procrastinates, and prays late into the night over discontinuing her comatose grandmother’s life support is reconceived as an inheritance-mongering opportunist, rubbing her fly-like hands together in the expectation of getting granny’s insurance policy five minutes and a potential lawsuit sooner."

    The article is long, but I would suggest at least listening to Keizer's interview on the Leonard Lopate Show here.

    As for Terri Schiavo case, I find it difficult to make a judgment. I sympathize with her parents, but I also sympathize with her husband. And as Keizer wrote, I believe some people demonize Schiavo's husband, trying to cast the situation as simply a case of devoted parents vs. disloyal husband.

    [Even later in the day]

    More food for thought: an article on Slate titled "Deathbed Conversion: The Lesson of Tom DeLay's Mortal Hypocrisy," about how DeLay (and his family) chose to let his father die after he suffered brain damage and went into a coma.


    Anonymous Vivian Darkbloom said...

    I don't find it difficult to take sides in the Terri Schiavo case. I would not for a minute want to live like that, and those right-wing religious fanatics (Schiavo's "supporters") who are out there picketing and beseeching Jeb or Congress or God to intervene aren't being honest with themselves or anyone else (not very Christian of them, aye?) if they say they would. Schiavo has become a political pawn of the neo-cons, or, as Hendrik Hertzberg puts it in the latest New Yorker "a metaphor in the religio-cultural struggle over abortion." That's a shame, and an disingenuous exacerbation of the pain of the situation for everyone involved.

    Coming from another angle, I have to wonder how it is that keeping someone alive at all costs with complicated medical technology is the correct way to carry out the "will of God"? How do people know they are correctly interpreting that will? And isn't it presumptuous to try to interpret what God wants anyway?

    Anyway, I don't even believe in a "sky God," as Gore Vidal would say, so maybe it's not fair for me to ruminate on this aspect. My main concern is that this whole spectacle or "passion play" (Hertzberg's apt description) is a major point for Team Anti-Abortion. We may find ourselves living in Margaret Atwood's Gilead yet.

    P.S. And Tom DeLay should talk about ethics while under investigation of the House ethics committee!
    P.P.S. I would just like to register my snaps for Atul Gawande. What an excellent writer! I've had a bit of a crush on him when I read his first piece in the New Yorker years ago--since then my heart goes aflutter whenever I espy a Medical Dispatch in the TOC....

    11:50 PM  

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