Care vs Cure

IMG_3290  Listen to link below

As I grow older, I wonder what my end will be like.

Recently, I received the above link in my email. A friend sent it with the comment “Inspiring.” (Unlike me, my friend is a person of few words.) She is right. It truly is inspiring.

As a nurse, I have long said that if I were ever diagnosed with pancreatic or ovarian cancer, I would opt to go on a cruise as opposed to going through treatments. I have seen too many people spend their last days in the hospital. I am not brave enough to be one of the “pioneers” that allows myself to be treated for a thus-far incurable disease. If I am going to die anyway, let me do so without all the surgeries and chemotherapy that have not been proven that successful.

Of course, if I had a disease that has been shown to be treatable such as breast or colon cancer, I definitely would give it a shot. But some diseases have proven to be difficult, if not impossible, to “cure” or even extend life that much. I’m all about “quality of life” not “quantity.” Why rack up major hospital bills, costing my family dearly, and why put myself through the pain of surgery and the side effects of chemo if its not going to help. In the end, we all die of something. Bless the people who have been strong enough to suffer through unproven treatments to help find cures. But I am not one of them.

So, like the priest in this podcast, I would opt for palliative treatment only, which means, a treatment that just keeps me comfortable as I die, not a treatment to “cure.”  To me, all the money spent at the end of life is often money poorly invested. I am not being “hopeless” or advocating euthanasia but rather being pragmatic. Options should always be weighed and educated decisions made. For example, if I were a young mother, I probably would not feel the same as I do now. This decision is not for everyone.

As a nurse, one of the problems I have seen is that people believe there is a cure for everything–we just need to find it. They put a lot of faith in the doctors. Keep in mind, too, that U.S. doctors are trained to “cure” so their focus is to prevent death. often at all costs. It is a futile endeavor, but they may try everything they can think of to keep someone alive. I have known doctors who view the death of a patient as a failure on their part. Nurses focus on relieving suffering. It is good we have the two professions. If all is going as it should, they balance each other out perfectly.

The saying is that “Doctors cure. Nurses care.” Nurses focus on the entire patient and how the illness will affect not only the physical well-being, but also the family, their socioeconomic happiness (how will she pay her bills, how will the illness affect her ability to work or care for her family, etc), her psycho-social health, etc.

Since I began my career in 1978, many changes have occurred. Now a “team approach” is more likely than the old “captain of the ship” approach where the doctors had the only say in what treatment should be given. (The smart doctors always listened to the nurses since it was/is the nurse who is present at the bedside and knows what is happening to the patient hour-by-hour.) Patients and families are included in the decision-making, instead of “the doctor knows best” approach.

As I age, these matters come to the forefront for me. It is never too early to plan for the end. Let your family know your philosophy and hopes for the future, be they short-term or long-term.

And, if you hear that I have booked a cruise, maybe, just maybe…(or it could be just my crazy cousin wanting to go on a trip.)

“End? No, the journey doesn’t end here. Death is just another path. One that we all must take.”
J.R.R. Tolkien, The Return of the King


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