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October07

Posted by:John Ellis
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Last month, Ezekiel Emanuel wrote a  controversial article in The Atlantic.  Entitled “Why I Hope to Die at 75”  He states:

But here is a simple truth that many of us seem to resist: living too long is also a loss. It renders many of us, if not disabled, then faltering and declining, a state that may not be worse than death but is nonetheless deprived. It robs us of our creativity and ability to contribute to work, society, the world. It transforms how people experience us, relate to us, and, most important, remember us. We are no longer remembered as vibrant and engaged but as feeble, ineffectual, even pathetic.

Many have construed his comments as a desire for “death panels” or withholding care to people over age 75.  As I read the article, I merely see him as asking this for himself and explaining why.  Having provided anesthesia for vascular surgery patients for a couple of decades, I (as we all are) are well acquainted with futile, expensive, end-of-life care.

For myself, I hope for 85 yrs, though!

Which reminds me of something.  I’ve always believed that clinicians are at their best approximately 10 years out of training, before slow decline begins.  Some people start out functioning at a higher level than others, and the rate of decline can vary sharply depending on genetics, habits, stress, etc.  Zeke’s article contains a chart (cartoon?) which depicts when high-achievers are most productive.

So, again, at what age do you think are clinicians at their best? How long do you wish to practice? To live?




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