This week we had an all too common clinical situation. A patient with severe chronic obstructive pulmonary disease (COPD) developed pneumonia. His prognosis because of his underlying disease is relatively poor.
Fortunately, the patient and his wife had previously discussed resuscitation and intubation. He does not want to go down that road. Because of this conversation we quickly went down the road to palliative care.
As we explained to the patient and his wife, we will treat his pneumonia with appropriate antibiotics, but we will also treat him. Sometimes in medicine we forget the patient. We focus on the disease or the prevention of a disease. But patients want us to treat them. They care about how they feel and that they are suffering.
The palliative care movement reminds us daily that we must focus on the patient at least as much as we focus on the disease. But often the patient's needs trump the recommended treatment of the disease.
Palliative care is truly patient-centered. It is family-centered. Palliative care brings humanity to medicine, a humanity that we risk forgetting. When we start medical school, most medical students come wanting to focus on that humanity. As we go through school and residency, and even in practice, we can become enamored with the science and treatments. Palliative care reminds us to maintain a balance between the science and the humanity.
We are fortunate to have palliative care physicians to remind us. We should not need that reminder, but we do. So we should all thank those dedicated physicians for helping us maintain our moral compass.
db is the nickname for Robert M. Centor, MD, FACP. db stands both for Dr. Bob and da boss. He is an academic general internist at the University of Alabama School of Medicine, and is the Regional Associate Dean for the Huntsville Regional Medical Campus of UASOM. He still makes inpatient rounds over 100 days each year. This post originally appeared at his blog, db's Medical Rants.