January 16, 2014
In the annals of Boston medicine two historic chapters in the last 50 years were the near conquest of sudden death by heart attack and (not unrelated) the rise of corporate, cathedral hospitals around the practice of heroic scientific medicine with a big arsenal of new drugs, surgical measures, bypasses, catheters and stents. Perhaps the core question is: where’s the better medicine that would make all of us all healthier, even without miracle surgery?
In the annals of Boston medicine two historic chapters in the last 50 years were the near conquest of sudden death by heart attack and (not unrelated) the rise of corporate, cathedral hospitals around the practice of heroic scientific medicine with a big arsenal of new drugs, surgical measures, bypasses, catheters and stents.
All this is the stuff of our guest Dr. Tom Lee’s biography of a giant cardiologist and an expanding industry in Boston. His book is Eugene Braunwald and the Rise of Modern Medicine, a complex and fascinating tale. Don Berwick – a doctor who’s running for governor — is covering the downsides all around this story: overtreatment for some, undertreatment for many, intrusions of finance and breakdowns in the humanity of doctoring, and of course gigantic expense.
We’re talking this hour about Boston’s bluest of blue-chip industries, medicine, in a prosperous maybe triumphant time that may also be the moment for rethinking and reform. Dr. Braunwald and Nobel Prize winner Bernard Lown make cameo appearances — drawn from longer podcast visits with each of them. Perhaps the core question is: where’s the better medicine that would make all of us all healthier, even without miracle surgery?
June 16, 2006
The Doctor has to be comfortable with accepting that death is not their own failure, but that death is a natural event, and that medical care can help people die with dignity and comfort. Christine ...
The Doctor has to be comfortable with accepting that death is not their own failure, but that death is a natural event, and that medical care can help people die with dignity and comfort.
What should the leading cause of death be? We’re all going to die. Someday. (Barring some incredible advances in medicine that confer virtual immortality on everyone.) How should that happen?
We frequently hear about how such-and-such — heart disease, cancer, obesity, accidents, AIDS — is the leading cause of death among a subgroup of the population, or the population as a whole. And that inspires us to donate money to searching for a cure for whatever that thing is, and it inspires us to change our behavior to reduce our risk for whatever that cause is.
And those are good things. Deaths from most of these things still come too early. And I doubt anyone really wants to die from painful cancers or AIDS or Alzheimer’s.
But if we’re all going to die, all things being equal, what should the leading cause of death be? Heart disease in old age? Cancer? Suicide, especially of the death-with-dignity variety? In short, what’s the ultimate goal of modern medicine, short of immortality?
Scarequotes, from Suggest a Show June, 2006
There are only two certainties in life: taxes, and we all know the other one. Advances in medical sciences are staving off the inevitable but once it comes the toll on the individual and on society can be huge. In this program we’ll discuss how to die. Does the most comfortable and painless death coincide with what is least costly to society? What toll will the ageing boomer population take on the US? How do you think about your own death? In this hour we’ll address the ethical, economic and philisophical components of what it means to die.
- Director of University of Pennsylvania’s Center for Bioethics
Christine K. Cassel, MD
- President and CEO of the American Board of Internal Medicine. Leading expert in geriatric medicine and end of life care.
- Author, The Naked Economist, and he teaches public policy at The Harris School at the University of Chicago
- Curt Tucker is a therapist, blogger and gallery owner. You heard his story at the end of this show.
- Extra Credit Reading
- Marilyn J. Field and Christine K. Cassel, ed., Approaching Death: Improving Care at the End of Life, The National Academies Press, 1997.
Hospice Guy, The Wharton School Weighs in on Hospice Care, Hospice Blog, June 6, 2006.
Christine K. Cassel and Katherine M. Foley, Principles for Care of Patients at the End of Life, December 1999.
Joao Pedro de Magalhaes, Should We Cure Aging? A Rebuttal of Myths About Immortality, Senescence, 2004.
Joao Pedro de Magalhaes, The Grandparents of Tomorrow: Winning the War Against Aging, Senescence, 2004.
Nurse Mia, Death Maiden.
Muriel R. Glick, The Denial of Aging: Perpetual Youth, Eternal Life, and Other Dangerous Fantasies, Harvard University Press, March 2006.