If a person has serious, complex illness, palliative specialists are happy to help. These are specialists in preventing and relieving the suffering of patients, and to see one, no determination of whether they are dying or not is required. The other half received usual oncology care plus parallel visits with a palliative care specialist. The researchers randomly assigned 151 patients with stage IV lung cancer, like Sara’s, to one of two possible approaches to treatment. “A landmark 2010 study from the Massachusetts General Hospital had even more startling findings. The peaks are important, and so is the ending.” Yet certain pleasures can make enduring suffering worthwhile. We do not want to endure long pain and short pleasure. A memory that neglects duration will not serve our preference for long pleasure and short pains.” When our time is limited and we are uncertain about how best to serve our priorities, we are forced to deal with the fact that both the experiencing self and the remembering self matter. But our memory … has evolved to represent the most intense moment of an episode of pain or pleasure (the peak) and the feelings when the episode was at its end. We want pain to be brief and pleasure to last. “We have strong preferences about the duration of our experiences of pain and pleasure. “An inconsistency is built into the design of our minds,” Kahneman observes. In favoring the moment of intense joy over steady happiness, the remembering self is hardly always wise. ![]() The peak and the ending are not the only things that count. Yet we also recognize that the experiencing self should not be ignored. Why would a football fan let a few flubbed minutes at the end of the game ruin three hours of bliss? Because a football game is a story. That is profoundly affected by how things ultimately turn out. Unlike your experiencing self-which is absorbed in the moment-your remembering self is attempting to recognize not only the peaks of joy and valleys of misery but also how the story works out as a whole. A seemingly difficult life may be devoted to a great cause. ![]() Measurements of people’s minute-by-minute levels of pleasure and pain miss this fundamental aspect of human existence. ![]() A story has a sense of a whole, and its arc is determined by the significant moments, the ones where something happens. For human beings, life is meaningful because it is a story. “In the end, people don’t view their life as merely the average of all of its moments-which, after all, is mostly nothing much plus some sleep. Whenever serious sickness or injury strikes and your body or mind breaks down, the vital questions are the same: What is your understanding of the situation and its potential outcomes? What are your fears and what are your hopes? What are the trade-offs you are willing to make and not willing to make? And what is the course of action that best serves this understanding?”īeing Mortal: Medicine and What Matters in the End Those reasons matter not just at the end of life, or when debility comes, but all along the way. And well-being is about the reasons one wishes to be alive. We think our job is to ensure health and survival. We’ve been wrong about what our job is in medicine. ![]() But again and again, I have seen the damage we in medicine do when we fail to acknowledge that such power is finite and always will be. Medical science has given us remarkable power to push against these limits, and the potential value of this power was a central reason I became a doctor. “Being mortal is about the struggle to cope with the constraints of our biology, with the limits set by genes and cells and flesh and bone.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |