Tuesday, August 16, 2011

How to tell emergency room patients that they're dying. - By Joanne Kenen - Slate Magazine

On television, the emergency room patients beat the odds. Their hearts get shocked back to life. Their organs get sewn up. They awaken to a handsome young physician's dazzling smile.

In real life, one in 500 ER patients—200,000 a year—dies under the bright lights of the emergency rooms. Another 500,000—3 percent—die during hospital stays following emergency treatment. Countless patients learn, from a doctor they have never seen before and may never see again, that they have fatal diseases. Others get treated, aggressively and repeatedly, for dangerous flare-ups in conditions like heart failure or emphysema without anyone having the time or the skills to explain that the chronic disease they have been living with is now the chronic disease that they are slowly dying from, a scenario Atul Gawande explored in his recent New Yorker piece on what doctors can do when they can no longer cure.

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