Michelle talks about doing anesthesia during an organ harvest:
So. About this 3am case. Organ harvest. Basically, brain dead guy, family consented to donate his kidneys, and we were there to collect. It was something I’d never done before, though I’d done anesthesia for the corresponding surgery on the other end of the arrow (the kidney recipient, I mean), and even though I’m all for organ donation–everyone make sure that little box on your driver’s license is checked right now, go on, I’ll wait–there’s something macabre about the term “organ harvest.” I don’t know, it calls to mind scythes and hoods and druids by moonlight. It sounds like, “Oooh, we grew this nice big juicy liver, and now it’s ripe for the picking!” Ghoulish.It was the easiest anesthesia I had ever done, because they guy was, you know, DEAD. And yet, so confusing, because he didn’t look dead. In fact, on the table, he looked exactly like all my other patients–intubated, pink, warm, lines running out of him every which way. It was easy enough to get started–move him to the table, hook up the vent, a little blood pressure control, let him ride–but I was confused with what we were supposed to do at the end.
Related posts:
- EMR realities
- No give, no take
- Organ donation incentive
- Hastening death to procure organs
- Last day of residency
- A fall from the surgical table
- Poll: How can we increase the supply of donor kidneys?
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{ 18 comments }
No wonder anesthesiologists can brag about how they’re decreasing risk in their specialty: What a low risk patient! I wish all my ER patients were this low risk (Though some of the heroin and oxy addicts could fit this guy’s description)
I share this dos’c uneasiness about the situation in which she found herself. Frankly I’m uneasy about the whole proposition of transplantation. I’m permanently disillusioned by my experience on the transplant service as an intern. I found the rather ghoulish anticipation of transplant candidates for the arrival of the next donorcycle a bit more than I could handle.
1% of patients consume 70% of the total healthcare dollar. Many transplant recipients are probably in that 1%. As a society we can’t afford it.
Are Physicians still in the business of helping people? you all talk as though you would like to kill us all off.
No, the lack of enough money in this world to fund every single life-saving effort under all circumstances is what’s going to kill us all off.
“Are Physicians still in the business of helping people? you all talk as though you would like to kill us all off.”
Should we help one person live a little bit longer at the expense of ignoring 99 people, or should we help the 99 and still try to give the one compassionate care but avoid going bankrupt in the process.
There is a limit and these questions have to be grappled with in order to do the most good for the largest number of people.
You guys are a HOOT!!In the real world of our everyday life, Drs. push for their patients to become organ donors. There are some docs. from hell that post on this blog.
“doctors frmo hell” Kill us all”
Nothing like over emotional responses to serious ethical and budgetary questions.
Keep name calling and creating straw men. THAT’S the ticket to resolving the serious problems of our time.
It’s not doctors that push for organ transplants…it is usually these pushy nurse practitioners or some allied type of medical worker who works for the transplant service…they have some kind of affiliation with critical care units and when there is a suitable candidate they get called in and then gang-bang the person on the ventilator and their family…
And if it was your child that needed a new organ to suvive, would you be “gangbanging” anyone?
“And if it was your child that needed a new organ to suvive, would you be “gangbanging” anyone?”
It depends on whether your wife was free that night or not…
“And if it was your child that needed a new organ to suvive, would you be “gangbanging” anyone?”
Ahh, the Oprah defense…If it was your mother….that’s how the lawyer sodomites poke us up the butt…
Ahhhhhhhh, your so good at skirting a question you don’t want to answer. Face it, you and I both know that if you were the subjective person seeking an organ donor, your attitute would be to find one as quickly as possible. Atleast for most humans it would be.
Are you human?
Anon 11:07, I see your point. I’m sure that doctor would move heaven and earth to get a donor organ if it were his own child, even if he won’t say it.
However, that line of thinking is simply not a practical way of determing appropriate public policy. Its the classic prisoner’s dilemma. What is good for one is not usually good for all, but to do what is good for all requires a certain individual sacrifice that people aren’t typically willing to make when it is their welfare (or a loved one’s) on the line.
That guy is probably right about what would be best for the majority of people in the long run, even though it comes at the profound detriment to a very few. But if it was my mother, yeah, rational logic probably would go out the window…
Yes, certain things I would try to move heaven and earth for. Other things are clearly futile and almost nearly torture that family members will put their loved ones or children through.
I think it should also be my responsibility to pay for it and not expect the taxpayer to fork out 250K that would immunize and entire third world country.
If you abuse drugs and get liver failure from HEP C does society owe you a new liver? Or if you are noncompliant and don’t control your HTN and DM does society owe you a new kidney? We can’t afford all of these things.
So, only the very weathy should be allowed to save their children?
I wonder what our future generations will think about us when they look back over history. They will surely think that we were the most barabaric of all creatures.
“In the year 20??, they let middle class and poor people (and their children) lay in the street and die, while Drs. walked over their little corpses to save their own asses.”
Its your profession your ruining, have at it!
I am sorry you don’t get “the most good for the most people” argument. you are too close minded to comprehend it. In reality, I think that is just what you want history to show but you are letting the emotional issue of a single case compromise the health of all the others.
What was the name of the actor in Il Postino? I believe he had cardiomypopathy, and in fact was dying of it during the filing of that lovely movie. He declined a heart transplant. I am not aware of him having shared his reasons for doing so. (It may have been something as simple as fear- though arguably a man who makes a conscious decision to forego a lifesaving operation is fearless.)
I’d like to think that he declined out of recognition that his time was up, and that to muster the tremendous resources neeed to save his one life was not justified. That is at any rate, how I hope that I will face the crisis should it ever arise.
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