Discursion: Hippocrates and Hypocrites

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Doctors talking about death are not unlike priests describing the horrors of hell: they speak with presumptive jurisdiction, but also an aloof conviction, almost pitying, that affirms it's not a place (death, hell) they'll ever find themselves. We can't despise them for this: without these affectations that eventually become ingrained, they couldn't conceivably perform their functions. Their comportment suggests that they've seen many of the things we pray to avoid, and have become intimate with horrors we can hardly imagine. In order to acclimate, they must first fortify themselves.

Physician, heal thyself?

It's understandable that so many of us assume doctors, who have more of everything-knowledge, money, connections-are able to take care of each other in ways their patients can't conceive. If this were indeed the case it would be comforting in a way. At least we would have irrefutable evidence that solutions do exist and we might look forward to one day employing them ourselves.

But the reality, if less polemical, is nevertheless enlightening. According to a growing field of first-hand testimonials, doctors do in fact tend to die differently, but not as a result of special or preferential treatment. The ultimate, paradoxical disparity lies in an intentional demurral of treatment. Less last-ditch cycles of chemotherapy or illusions of a few extra months. Which begs the complicated question: does more time with more adversity (physical if not mental) seem in any way appealing?

This phenomenon, which could simply and accurately be described as acceptance, illustrates several things. The most revealing might be that doctors, because they see so much avoidable anguish, are disinclined to die in denial when their own diagnoses stare back at them in black and white. Aware of how little can be done, and able to measure the difference between best intentions and bottom lines, some prepare accordingly. In the process, perhaps they're able to provide a measure of peace-and not the opposite-for themselves and their families.

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