After an accident that took away my ability to operate, I was in a body cast and had time to reflect on what it meant as a patient to entrust your life with the world of medicine. As a cardiac surgeon, I was used to being the one in control. The operating room is like a symphony orchestra with multiple moving parts, all needing to be in tune with the other to yield a reproducible product. I have experienced numerous aspects of the continuum of care throughout my life. I started as a nurses aide in a nursing home when I was in high school, an EMT in college and then progressed to medical school, residency, fellowship and then private practice. This influenced my thoughts on “Convince Me.” Mary Bourland, MD
Convince me when you treat me that:
- You will be honest.
- The treatment will not harm me in years to come.
- You would give the medicine you give me to your own family.
- You will not refer me to a colleague that to whom you would never go.
- If I have surgery you have helped me sort through the all the options.
- Fear does not drive my decision or yours.
- You respect my choices, even if it’s not what you would choose.
- My life plan also includes an end plan.
Convince me when I am operated on that:
- I am protected.
- When my body is opened it is treated like the temple it is.
- The team you entrust it to will respect it as I do.
- When the surgeon leaves I am left in good hands to put me back together, take me upstairs, and deliver me while asleep to someone who cares, who protects my skin, my breath, my beating heart….to someone who will fight anyone who tries to harm me….to someone who doesn’t think they are infallible and takes the time to double and triple check what they inject into me.
Convince me when you send me home that:
- You will help my family prepare for unknown events, for costly medications, for fearful anxiety.
- When you send me to rehab, it’s somewhere you would send your family with clean floors and decent food, and with staff that cares and not just doing their time.
- Home health nurses will respect my home and treat me and my home with dignity.
Convince me when I’m old and ready to pass into the next life that:
- You won’t say no.
- You won’t hook me up to tubes and machines because you can’t say goodbye.
- If I no longer know who I am that nothing will be done to prolong my life, even an antibiotic.
- You won’t let them enter my body with a surgical knife without permission.
- You know what I want and how I want to die.
- You understand how death is a part of life, it’s not defeat…it’s life.
Please, convince me.
Mary Bourland, M.D.
First posted on Cracking Health Costs on 02/01/2013