Blog | Wednesday, June 10, 2015

Champagne on our deathbeds

I attended a recent conference where the keynote was given by a well-known writer who also happens to be a doctor: Abraham Verghese.

Verghese is the author of a memoir called “My Own Country” that I consider formative in my own career. It was about his life as doctor specializing in infectious diseases in small town Tennessee during the early days of the AIDS epidemic. After I read it I wrote him a letter, and he was kind enough to reply. I still have the letter.

He wrote a second memoir about a trainee called “The Tennis Partner,” a very powerful story of the trainee's demons. For his third book he crossed over into fiction with the novel “Cutting for Stone.”

During his keynote Verghese discussed mortality, reminding us that in spite of gains in longevity, the death rate for human beings still is 100%. Immortality, he argued, is overrated.

He also distinguished between curing and healing, making the claim that we strive so hard for the former we essentially forget about the latter. If your home is robbed, your personal sense of security is assaulted. If your possessions are returned, you are ‘cured’ of the property crime, but won't feel healed for some time.

As another example, he discussed caring for young men with AIDS for whom there was no treatment in the 1980s. Yet by attending to them on their deathbeds, he provided solace as they reunited with their families. This was a form of healing.

He also read a passage to the audience about the death of Anton Chekhov, late 19th-early 20th century Russian doctor and writer of plays and short stories.

Chekhov, stricken with tuberculosis, asked his wife Olga to take him to a Black Forest spa when he knew death was imminent. There, she recalled in her own memoir: “Anton sat up unusually straight and said loudly and clearly (although he knew almost no German): Ich sterbe (“I'm dying”). The doctor calmed him, took a syringe, gave him an injection of camphor, and ordered champagne. Anton took a full glass, examined it, smiled at me and said: “It's a long time since I drank champagne.” He drained it and lay quietly on his left side, and I just had time to run to him and lean across the bed and call to him, but he had stopped breathing and was sleeping peacefully as a child …”

Verghese encouraged us all to think about how we want to leave this earth—and to tell our loved ones—lest we wind up in hospitals tethered to machines.

This post by John H. Schumann, MD, FACP, originally appeared at GlassHospital. Dr. Schumann is a general internist. His blog, GlassHospital, seeks to bring transparency to medical practice and to improve the patient experience.