Too honest?

[+ WilliamM]

I'm a little puzzled. You weren't his doctor, or even his nurse. Wouldn't the correct response be "I would ask your doctor..."? He probably gave up hope that night. Who told you he was about to die? Were you the appropriate person to give him this death sentence?

Yes he was the appropriate person. He deserves respect.

[+ nycman]

I'm a little puzzled.

Unicorn?....seriously?

You're not confused. You're being cunty.

Wouldn't the correct response be "I would ask your doctor..."?

Yes, his medical team should have addressed the issue sooner.

Unfortunately, they often don't have the balls to do so.

I've seen a young woman with 3 primary cancers (brain, lung and ovarian) that were all metastatic, confused that she was about to die.

No one had told told her condition was terminal.

It was insane, inhumane, and irresponsible.

But I blame her physicians, not the orderly that comforted her as she gasped her last breath.

He probably gave up hope that night.

What a stupid dip shit thing to say. Seriously dude, did you even sit through ONE class in medical school?

Please point me to the section in the pathophysiology textbook about "hope".

And even if your moronic "hope/death" theory is correct, since when is it wrong for an old man to accept death?

Who told you he was about to die?

In my experience orderlies usually know best when someone is about to die, not asinine doctors who pontificate about "hope".

Were you the appropriate person to give him this death sentence?

No, no he wasn't. But as is often the case, the rest of the patient's medical team had failed him miserably.

 

Rudynate, you did NOTHING wrong.

You are a Hero in my eyes and I'm sure a Saint in the eyes of that dying man.

 

Unicorn?....go pick on someone your own size.

Edited January 2, 2020 by nycman

[+ WilliamM]

What a stupid dip shit thing to say. Seriously dude, did you even sit through ONE class in medical school?

Please point me to the section in the pathophysiology textbook about "hope".

And even if your moronic "hope/death" theory is correct, since when is it wrong for an old man to accept death?

Was @Unicorn insensitive? Yes, but i am not sure he deserved a long, somewhat angry response

[rvwnsd]

I think it was more like you shouldn't be too trusting that other people are honest. And maybe not be too forthcoming about, say, your financial condition. eg let them know you're willing to spend on a good time, don't let on right away that you are well-heeled enough to support them full-time.

 

Excellent summary. Also excellent advice that can be applied to different situations. Thank you.

 

Happy New Year!

 

Often kindness and honesty are conflicting. When my mother asks if I like her new blouse,...

 

To me, you are being honest when you say

 

..."your smile tells me you like it very much" ...

 

assuming you mother was smiling at the time.

 

...I find kindness is easy to choose when honesty can be hurtful on things that don't matter.

It sounds like you have perfected an ability to be honest without being critical or mean.

 

As to this little interchange:

 

I'm a little puzzled. You weren't his doctor, or even his nurse. Wouldn't the correct response be "I would ask your doctor..."? He probably gave up hope that night. Who told you he was about to die? Were you the appropriate person to give him this death sentence?

Perhaps this is an example of practicing being "not nice." (Note how I am practicing being "nice")

 

and this

 

Unicorn?....seriously?

You're not confused. You're being cunty.

 

Yes, his medical team should have addressed the issue sooner.

Unfortunately, they often don't have the balls to do so.

I've seen a young woman with 3 primary cancers (brain, lung and ovarian) that were all metastatic, confused that she was about to die.

No one had told told her condition was terminal.

It was insane, inhumane, and irresponsible.

But I blame her physicians, not the orderly that comforted her as she gasped her last breath.

 

What a stupid dip shit thing to say. Seriously dude, did you even sit through ONE class in medical school?

Please point me to the section in the pathophysiology textbook about "hope".

And even if your moronic "hope/death" theory is correct, since when is it wrong for an old man to accept death?

 

In my experience orderlies usually know best when someone is about to die, not asinine doctors who pontificate about "hope".

 

No, no he wasn't. But as is often the case, the rest of the patient's medical team had failed him miserably.

 

Rudynate, you did NOTHING wrong.

You are a Hero in my eyes and I'm sure a Saint in the eyes of that dying man.

 

Unicorn?....go pick on someone your own size.

 

is one of the best take-downs. You took the words right out of my keyboard, @nycman.

[Deadlift1]

Narcissistic Personality Disorder

[+ WilliamM]

Narcissistic Personality Disorder

Yes. More revealing than @Unicorn may have realized.

[Rudynate]

.

 

In my experience orderlies usually know best when someone is about to die, not asinine doctors who pontificate about "hope".

 

.

 

 

That always puzzled me about doctors. They spent seconds, maybe minutes per day with their patients. The nursing staff spent literal hours with them every day, in intimate contact. Of course we knew more about their patients than they did.

 

 

And you're right @nycman. In a setting like the VA, death is pretty common. Even a moron learns to read the signs of impending death pretty quickly.

Edited January 2, 2020 by Rudynate

[Guest]

... You're being cunty.

....

What a stupid dip shit thing to say....

I'm sorry if everyone else disagrees, but slinging insults doesn't make you right. I asked in my prior post how Rudy knew that patient was about to die. An orderly should not have access to a patient's chart, so it leaves open the question as to why Rudy felt so confident with his opinion that he could (or should) offer it to the patient. When my mother was dying in her hospital bed last May, my sibs and I asked the attending physician and the hospice RN, who's seen hundreds of dying cancer patients, how much longer they thought my mother would survive. Both of them gave a similar response: "It could be hours or it could be weeks." As it turned out, she was discharged to her extended care facility the next day with a hospice RN, and passed away about 8 hours after the transfer (she was essentially in a coma).

If highly experienced and trained medical professionals have seen things go differently for different patients in similar situations, and feel it's not possible to make accurate predictions, it makes me wonder how a person with no formal medical education or access to the patient's records could feel so certain. And those of you who think that suggestibility doesn't affect patient outcomes should look at almost any randomized clinical trial. There's always a placebo effect. Often, in fact, the placebo effect is more potent than the effect of the medication itself (the only thing the FDA requires to approve the medication is that the difference between the placebo effect and the medication effect is statistically signifiant). This is especially true for medications in the mental health field.

If you disagree with someone, and you use insults rather than rational discourse to get to your point, you're probably speaking on an emotional rather than a rational basis.

[+ WilliamM]

First of all, condolences on the passing of your mom last year...aging and dying parents is not for the faint of heart, not easy to watch and difficult to come to terms with at times. As for the gentleman in the hospital, he likely knew that his life was ebbing away, so having it confirmed by a kind orderly likely put him at ease and made him feel more at peace with what was happening. Uncertainty about death can be way more unsettling. After accepting what was told, which he seemed to do, he likely had time to consider eternity and his place in it. And hearing ftom a doctor may have been a clinical and negative interaction him. I agree with you that turn-arounds can happen and that it is importance to not give up, but end stage cancer is a different beast. Only divine intervention could have saved that man, and i think divine intervention was present by ensuring the orderly was at hand having the courage to gently express the truth...and that this gave the man the peecious gift of having a 'good death'.

 

Superb response and just when it as most needed.

[Rudynate]

I'm sorry if everyone else disagrees, but slinging insults doesn't make you right. I asked in my prior post how Rudy knew that patient was about to die. An orderly should not have access to a patient's chart, so it leaves open the question as to why Rudy felt so confident with his opinion that he could (or should) offer it to the patient. When my mother was dying in her hospital bed last May, my sibs and I asked the attending physician and the hospice RN, who's seen hundreds of dying cancer patients, how much longer they thought my mother would survive. Both of them gave a similar response: "It could be hours or it could be weeks." As it turned out, she was discharged to her extended care facility the next day with a hospice RN, and passed away about 8 hours after the transfer (she was essentially in a coma).

If highly experienced and trained medical professionals have seen things go differently for different patients in similar situations, and feel it's not possible to make accurate predictions, it makes me wonder how a person with no formal medical education or access to the patient's records could feel so certain. And those of you who think that suggestibility doesn't affect patient outcomes should look at almost any randomized clinical trial. There's always a placebo effect. Often, in fact, the placebo effect is more potent than the effect of the medication itself (the only thing the FDA requires to approve the medication is that the difference between the placebo effect and the medication effect is statistically signifiant). This is especially true for medications in the mental health field.

If you disagree with someone, and you use insults rather than rational discourse to get to your point, you're probably speaking on an emotional rather than a rational basis.

 

 

Youve obviously never been a hospitalist and have very little notion of how inpatient units are run. The nursing staff knows all of that. It is extensively discussed during the report at change of shift. You think they keep information like a patient's prognosis secret from certain of the staff? How could they care for their patient's effectively if they didn't know everything about the patient?

 

 

How do you know that I didn't have access to the patient's chart? Bear in mind that this was 45 years ago, long before HIPAA. In fact I could go in the nurse's station and look at any chart I wanted to. In fact, In made entries in the nursing notes which became part of the patient's chart. Another example of you speculating about something you know nothing about and looking like an idiot because of it. I think in some quarters those people are called know-it-all's. I call them people with poor self-esteem.

 

And you seem to have interpreted this as me "stepping out of line" when, in fact it was me dealing the best I could with a difficult situation created by the professionals caring for the guy who hadn't done their job. But that was common then. Dr's. were loathe to discuss death and dying with their terminal patients. They preferred spending untold amounts of money delaying the patient's last breath as long as they could, with no thought to the patient's quality of life. You seem like a Dr. in the old mold.

Edited January 3, 2020 by Rudynate

[+ WilliamM]

I'm sorry if everyone else disagrees, but slinging insults doesn't make you right. I asked in my prior post how Rudy knew that patient was about to die. An orderly should not have access to a patient's chart, so it leaves open the question as to why Rudy felt so confident with his opinion that he could (or should) offer it to the patient. When my mother was dying in her hospital bed last May, my sibs and I asked the attending physician and the hospice RN, who's seen hundreds of dying cancer patients, how much longer they thought my mother would survive. Both of them gave a similar response: "It could be hours or it could be weeks." As it turned out, she was discharged to her extended care facility the next day with a hospice RN, and passed away about 8 hours after the transfer (she was essentially in a coma).

If highly experienced and trained medical professionals have seen things go differently for different patients in similar situations, and feel it's not possible to make accurate predictions, it makes me wonder how a person with no formal medical education or access to the patient's records could feel so certain. And those of you who think that suggestibility doesn't affect patient outcomes should look at almost any randomized clinical trial. There's always a placebo effect. Often, in fact, the placebo effect is more potent than the effect of the medication itself (the only thing the FDA requires to approve the medication is that the difference between the placebo effect and the medication effect is statistically signifiant). This is especially true for medications in the mental health field.

If you disagree with someone, and you use insults rather than rational discourse to get to your point, you're probably speaking on an emotional rather than a rational basis.

 

Perhaps occasionally better to speak on an emotional level about dying.

 

Just a casual observation, @Unicorn

[Antonio1981]

Stay the way you are. We need more people like you!

[Deadlift1]

Narcs have no empathy for other people. He will go on and on about why he was right without saying I'm sorry for being harsh. He just let a little narc rage slip out.

[Guest]

Youve obviously never been a hospitalist and have very little notion of how inpatient units are run. ....How do you know that I didn't have access to the patient's chart? Bear in mind that this was 45 years ago, long before HIPAA. In fact I could go in the nurse's station and look at any chart I wanted to. In fact, In made entries in the nursing notes which became part of the patient's chart. Another example of you speculating about something you know nothing about and looking like an idiot because of it. ...

 

Ironic. I never said I knew you didn't have access to the patient's chart. My "statement" was "Who told you he was about to die?". I did inpatient work from 1986 to about 2002, and at no time during this period were orderlies ever allowed access to patients' charts, nor included in nurse or physician rounds. So actually YOU are the one who speculated about something you knew nothing about. Who looks like an idiot now, in your own words? No, I don't know how things went in the 70s. Nor was I around when they drilled holes in peoples' heads to get rid of evil spirits.

[+ FreshFluff]

I'm a little puzzled. You weren't his doctor, or even his nurse. Wouldn't the correct response be "I would ask your doctor..."? He probably gave up hope that night. Who told you he was about to die? Were you the appropriate person to give him this death sentence?

 

I understand your point, Unicorn. Even though the asked, maybe he wasn't ready to hear the answer. But there was so little time left to tell him, so I can understand why Rudynate took the initiative. Otherwise, he might have died without getting his affairs in order, calling loved ones to his bedside, etc.

[Rudynate]

Ironic. I never said I knew you didn't have access to the patient's chart. My "statement" was "Who told you he was about to die?". I did inpatient work from 1986 to about 2002, and at no time during this period were orderlies ever allowed access to patients' charts, nor included in nurse or physician rounds. So actually YOU are the one who speculated about something you knew nothing about. Who looks like an idiot now, in your own words? No, I don't know how things went in the 70s. Nor was I around when they drilled holes in peoples' heads to get rid of evil spirits.

 

 

And much like our president you make careless ststements and then say you never made them even though the evidence is there for all to see. You DID say that as an orderly, I couldn't have had access to his chart.

 

And you seem to be assuming that I told him he was going to die within a particular time period. I told him he would die "probably very soon." That could be three hours or three weeks. Compared to an entire life span either period is very soon. And "probably" makes the statement even more indefinite.

 

And who told me he was going to die? The charge nurse relayed that information during the report. She wouldn't have pulled that out of her ass. It would have been in the admission orders or the physician's notes written by the admitting physician.

 

You also again are speculating about the patient, the course of his illness, his treatment, his condition on admission. Hospice was a brand new concept and hadn't been widely implemented. Now he would have been admitted specifically for hospice care. At that time, he was admitted with the explicit understanding that he was there to die.

 

You allowed a bunch of unwarranted assumptiobs to color your statements and ended up looking like a fool. But then, that's what you do.

 

It's curious, the passion you're expending on litigating an event that occurred nearly 50 years ago. Kind of like Trump and the hurricane.

Edited January 3, 2020 by Rudynate

[+ WilliamM]

I understand your point, Unicorn. Even though the asked, maybe he wasn't ready to hear the answer. But there was so little time left to tell him, so I can understand why Rudynate took the initiative. Otherwise, he might have died without getting his affairs in order, calling loved ones to his bedside, etc.

 

One of your very best comments out of many, @FreshFluff.

[+ WilliamM]

And much like our president you make careless ststements and then say you never made them even though the evidence is there for all to see. You DID say that as an orderly, I couldn't have had access to his chart.

 

And you seem to be assuming that I told him he was going to die within a particular time period. I told him he would die "probably very soon." That could be three hours or three weeks. Compared to an entire life span either period is very soon. And "probably" makes the statement even more indefinite.

 

And who told me he was going to die? The charge nurse relayed that information during the report. She wouldn't have pulled that out of her ass. It would have been in the admission orders or the physician's notes written by the admitting physician.

 

You also again are speculating about the patient, the course of his illness, his treatment, his condition on admission. Hospice was a brand new concept and hadn't been widely implemented. Now he would have been admitted specifically for hospice care. At that time, he was admitted with the explicit understanding that he was there to die.

 

You allowed a bunch of unwarranted assumptiobs to color your statements and ended up looking like a fool. But then, that's what you do.

 

It's curious, the passion you're expending on litigating an event that occurred nearly 50 years ago. Kind of like Trump and the hurricane.

 

Now I fully understand why you are pissed. Very sorry this happened.

[Rudynate]

Now I fully understand why you are pissed. Very sorry this happened.

 

Unicorn and I have always had a contentious relationship.

[Guest]

...

And who told me he was going to die? The charge nurse relayed that information during the report....

 

Obviously I don't know what was standard medical practice 50 years ago. It could be that time, orderlies had access to privileged medical information, and that physicians refused to answer patients' questions when queried about their prognosis. If that's the case, I apologize for my confusion. I can only say that this is very contrary to anything approaching my experience of over 30 years. These days (and for the last 30 years), if an orderly tried to access a patient's medical chart, he would probably be fired, or at the very least disciplined. Discussing a patient's prognosis would also probably result in some counseling, although this would not be considered as serious as accessing a chart without authorization. I was thinking that when I go back to work on Monday, I'd ask someone who was working in the 70s, but I don't think there are still people around working now who were working in the 70s, so I'll take your word for it. Inappropriate access to patient records, if it comes to the attention of authorities, results in minimum fines of $10,000 per occurrence. Penalties can be even more severe depending on the circumstances of the violation.

[Guest]

Unicorn and I have always had a contentious relationship.

I don't keep tabs of people who've been on my bad side (for the most part), but it is curious. I guess I'll probably remember for the future.

[instudiocity]

Obviously I don't know what was standard medical practice 50 years ago. It could be that time, orderlies had access to privileged medical information, and that physicians refused to answer patients' questions when queried about their prognosis. If that's the case, I apologize for my confusion. I can only say that this is very contrary to anything approaching my experience of over 30 years. These days (and for the last 30 years), if an orderly tried to access a patient's medical chart, he would probably be fired, or at the very least disciplined. Discussing a patient's prognosis would also probably result in some counseling, although this would not be considered as serious as accessing a chart without authorization. I was thinking that when I go back to work on Monday, I'd ask someone who was working in the 70s, but I don't think there are still people around working now who were working in the 70s, so I'll take your word for it. Inappropriate access to patient records, if it comes to the attention of authorities, results in minimum fines of $10,000 per occurrence. Penalties can be even more severe depending on the circumstances of the violation.

Interestingly, one of my physicians graduated college in 1956. He’s been practicing medicine nearly 60 years. Maybe you retired early?

[Guest]

Interestingly, one of my physicians graduated college in 1956. He’s been practicing medicine nearly 60 years. Maybe you retired early?

I haven't quite retired yet, but if your physician graduated from college in 1956, and is still practicing medicine, I think that's very said--no matter how much he enjoys the practice of medicine. In my opinion, anyone working in his 80s is a sad thing. Just my opinion, mind you.

[+ sniper]

I haven't quite retired yet, but if your physician graduated from college in 1956, and is still practicing medicine, I think that's very said--no matter how much he enjoys the practice of medicine. In my opinion, anyone working in his 80s is a sad thing. Just my opinion, mind you.

If you're at the point where you set your own hours and love your job, how is it sad? Some people feel a calling. As the saying goes, Love what you do for a living and you'll never work a day in your life.

Historically, doctors never retiring used to be the norm. Hence they had just about the lowest rates for long-term disability insurance. Then sometime in the 80s or 90s they started getting fed up with corporatized healthcare and started signing off on each others' "disabilities" to retire early and premiums went way up.

[+ WilliamM]

If you're at the point where you set your own hours and love your job, how is it sad? Some people feel a calling. As the saying goes, Love what you do for a living and you'll never work a day in your life.

Historically, doctors never retiring used to be the norm. Hence they had just about the lowest rates for long-term disability insurance. Then sometime in the 80s or 90s they started getting fed up with corporatized healthcare and started signing off on each others' "disabilities" to retire early and premiums went way up.

 

Excellent comment.