Sunday, December 14, 2008

grey's anatomy

i had a middle-aged patient who underwent 3 surgeries without improvement. it's unfair to pronounce judgement as to whether the patient should have been subjected to the traumatic experience, based solely on hindsight which we all know to be 100% accurate.

so how do doctors make crucial decisions? consider the facts:

1) the patient had a fall which resulted in multiple blood clots on both sides of the brain;

2) doctor#1 told his family that there's severe brain injury & survival is slim, even with surgery;

3) the family sought a 2nd opinion & doc#2 concurred with doc#1;

4) it was commendable that the family undertook to consent for surgery, & subsequently 2 further procedures, but in the end, it was futile;

doctors are not God, although some may behave like one. however, we do well with our God-given knowledge & skills when we provide the available treatment options & explain each on its own merits, so that the patient and/or the family can deliberate & make an informed decision.

in medicine, results can go either way - the same treatment given to different patients can end in different outcomes. it's never an exact science (or art). there are always grey areas where the unknown & unexplained thrive.

it just occured to me that maybe, just maybe, that's why the TV series is called Grey's Anatomy. could it be that it's never about Meredith the intern-now-turned-resident but rather about the uncertainties the patients & their doctors encounter daily? that sometimes even with the top experts, high-end diagnostic tools & most advanced drugs, the patient dies while another, left on his own may miraculously survive?

i pray for wisdom & discernment as we deal with our patients' fear & concern.


"Pay attention, Job, and listen to me;
be silent, and I will speak.

If you have anything to say, answer me;
speak up, for I want you to be cleared.

But if not, then listen to me;
be silent, and I will teach you wisdom."

Job 33:31-33


Alex Tang said...

good meditation on the practice of medicine. If only our patients understand that and do not expect us to perform miracles.

Anonymous said...

I'm a fan of the show & it taught me that people (doctors & patients included) don't want advice but understanding.

iml said...

I agree. Even going to the best surgeon in the best equipped OT, there is still the element of risk. Fatalism.

doc said...

hi Alex,

unfortunately, the norm in private practice is for patients not only to expect but sometimes DEMAND miracles because they think private docs are the best (not always true) & money can buy anything (absolute myth!).

doc said...


i was a fan but i've stopped watching the current season. i may reconsider when Meredith dumps McDreamy!!

(which means i may never watch another episode ever!!)

doc said...


even crossing a road is risky!

Kyels said...

I love Grey's Anatomy and it's not about doctors playing God but how they should come to understand the patients and their needs/wishes. That's what I think and there's no way one can push what he/she thinks is best for them.

doc said...


that's how i also think doctors shd portray themselves - care-givers without being judgmental or authoritarian.

zewt said...

i must admit... your reasoning on why it's called grey's anatomy made a lot of sense...

zewt said...

hmm... how come my comment didnt come up...

doc said...


i believe it's called a moment of inspiration, which i could do with more often.

sometimes when the server is clogged up, i guess it takes awhile before the comments appear.