"She will not die. She does not have that permission from me."

[pockunit]

Did anyone else have a problem with this quote from the neurologist about Rep. Giffords?

YOU DON'T GET TO GIVE PERMISSION.

I get that he was using levity in a very dark situation. But it's representative of a general school of thought that very likely helps lead to overtreatment in futile situations.

But I may be crabby.

[Batman25]

I don't have an issue with this statement in the least. A little humor during a dark time can be a wonderful thing. It sounds like the patient is in caring and competent hands. My prayers go out to her for a full recovery.

[canesdukegirl, BSN, RN]

i don't have a problem at all with the statement.

and i don't believe he was being "humorous".

in hospice, we OFTEN ask the families, to "give permission" to die, to the pt.

often, pts linger and there are reasons for them doing so.

one of these reasons, is r/t an inability to let go...to die, fearing leaving their beloveds behind.

and so, when we gently encourage loved ones to "give permission....that i'll be ok, i'll miss you, but will see you at another time"...we see that only then, the pts can finally let go.

that said, i do believe that the dr. was specifically telling her she cannot die...

that she's a viable, 40yo woman who has a chance...so don't give up.

very reasonable AND smart move, imo.

leslie

Well said, my girl. And there is so much truth behind your statements. When my mother was dying-and I mean in the active stages of dying-it was only when my little brother returned early from his honeymoon, went straight to her bed, took her hand and whispered in her ear, "Mom, I am here. We are all here. We will take care of each other. You have taught us well and we can do this. We will miss you but we know that you will never be far." She passed only a few minutes later. We did take care of each other, and we feel her presence all the time.

It is true that some patients hang on until they are "given permission". I always thought that this was such a hokey statement before I actually witnessed it. I think the doc was not grandstanding in this instance, but that he was giving this brave woman a burst of "tough love" if you will. He has the weight of the world on his shoulders, I imagine and that can't feel good for him. I continue to pull for this woman, her medical team and her family. She has a long road ahead of her.

[leslie :-D]

what really ticks me off, is when pts should be able to die, and the docs won't let them.

let's face it: dr's have the ability to sustain or cease life, for the most part.

and they make lots of bad decisions.

God, they are not, no doubt.

leslie

[pockunit, ADN, RN]

Yes. I don't think he meant it literally. But what he said, in the context of medical history, underlines an attitude that so many docs have. It's an attitude that they have perpetuated, and that many, *many* people still believe.

When Palin used the term "blood libel," people were upset because of the historical context of those words. There's a history behind them. Even calling someone a Yankee carries a lot of baggage. Depending on context, it can be a compliment or a slur.

His quote, in this context, displays a line of thinking many medical schools still seem to teach. I know he wasn't speaking as a Representative Of Medicine. People say things under the spotlight that are unfortunate. But what he said comes from a school of thought that is based on a paternalistic, dictatorial, I-know-best-just-do-as-I-say attitude. Docs didn't used to tell people if they were terminally ill because the patient didn't need that information. Women were strapped to beds and totally snowed during labor. Nurses were expected to give docs their seats and stand when a doc entered the room. We learn about the history of nursing so we can put current practice into context.

His words harken back to an era we should be moving away from. I'm not saying he's a bad doc. I'm not saying he's a bad person. I just want docs to start fighting the stereotype he underscored with that comment.

Does that make sense?

[canesdukegirl, BSN, RN]

I see what you mean, but I still don't think this neurosurgeon was spouting the "I know best just do as I say" mentality. I think he was actually giving hope to Giffords and her family by exercising a tough love sentiment. Neurosurgery and neurology are such complicated fields, and we have just begun to embark on specific treatments and remedies to counteract the injuries that our patients suffer from. One thing that docs use as a tool is to rally the patient to survive. It can seem like a cold hearted measure to say "You do not have my permission to die", but the intent is to make the patient FIGHT. I believe that is just what he was doing.

[pockunit, ADN, RN]

I see what you mean, but I still don't think this neurosurgeon was spouting the "I know best just do as I say" mentality. I think he was actually giving hope to Giffords and her family by exercising a tough love sentiment. Neurosurgery and neurology are such complicated fields, and we have just begun to embark on specific treatments and remedies to counteract the injuries that our patients suffer from. One thing that docs use as a tool is to rally the patient to survive. It can seem like a cold hearted measure to say "You do not have my permission to die", but the intent is to make the patient FIGHT. I believe that is just what he was doing.

Yes. And again, I don't think it's necessarily HIS attitude, just one of docs in general. I only wish he'd said it to her and her family and something less ... I don't know, cocky? ... to the news. Saying it to her is helpful. Saying it to us is not.

[canesdukegirl, BSN, RN]

Yes. And again, I don't think it's necessarily HIS attitude, just one of docs in general. I only wish he'd said it to her and her family and something less ... I don't know, cocky? ... to the news. Saying it to her is helpful. Saying it to us is not.

I feel ya.

[sicushells, RN]

I heard the audio clip on my way to work last night and it's been bothering me since, too.

It's not the he said it all- it's that he said it to the public. He also said something to the effect of, "I won't allow her to have any sort of neuro affects. She's going to be just fine." Umm...dude... you aren't a Time Lord. You can't go back and un-shoot her brain.

[linearthinker, DNP, RN]

The emotional energy expended over innocuous and inconsequential mutterings of strangers is an odd phenomena.

[pockunit, ADN, RN]

Yet you keep reading and posting on the thread.

[linearthinker, DNP, RN]

Am I not supposed to because I think you are reactionary?

[pockunit, ADN, RN]

You find it odd that I'm "reactionary", and I find it amusing that you still engage. No "supposed to" about it.