Sudden death makes a mockery of preventive medicine

Here today, gone tomorrow.  The older I get, the more often I get the call: “This is the ER at Any Hospital, can you hold for Dr. X?”  Dr. X then comes on the line and tells me my patient had a catastrophic event, that the paramedics and ER crew did everything possible but that the patient expired.

My patient had no reason to die.  He was relatively young and healthy. Life had been good to him and he had been good to his body.  He didn’t die in an auto accident or on a ski slope.  He died at home and apparently, from nothing.  I can’t describe the feelings of loss, frustration, curiosity, and wonderment that accompany such an unexpected call.

Yes, people die from nothing.  In my world, it’s not uncommon to lose perfectly healthy patients.  Usually they die in an accident; but, occasionally, they just die.  Sudden death is a mean foe.  Sudden death gives you no time to react and is almost always permanent.  Sudden death also denies family and friends a chance to prepare for the loss.

As a doctor, the tsunami of emotions accompanying “the call” begin with loss.  He was one of those patients who always made me smile.  Even when he was miserably sick with a cold, he always had something nice to say.  When his life’s stresses mounted, he always found the positive side.  Yes, his death is a tremendous loss to my practice and the community.

When patients get it right, cares for themselves, follow the rules and still die from nothing, it’s frustrating.  I believe in preventative medicine.  There are healthy habits and there are those habits that are unhealthy.  Eliminating unhealthy habits, eating right, stressing less, enjoying life, and exercising should be rewarded with long life.  When a patient who does it right just dies, it makes me want to drown myself in hot dogs and chocolate cake!  I think I’ll go to Portillo’s and throw my own wake.

Curiosity strikes next.  Why?  Everyone wants to know why?  The pathologist is the doc who answers that question.  The pathologist is the doc who knows everything.  Unfortunately, the pathologist knows everything; it’s just too late.  Autopsies help answer the question why.  Hopefully, by answering the “why,” families can mourn in peace and docs can accumulate wisdom that can help them become better docs.  Unfortunately, there are times when even the best pathologist cannot answer the “why” and everyone has to accept that, in death as in life, there are questions that will never be answered.

Did “wonderment” seem like an inappropriate emotion when I listed it above?  It’s not.  I am always awed by how precarious life really is and how much people take it for granted!  If today is your last day, are you going to enjoy it or are you going to waste it worrying about tomorrow?  Do you have an “attitude of gratitude” or are you so involved with life’s stresses that you forget to give thanks for what you have?

If today is your last day, did you contribute to your demise by neglecting your health?  Did you waste your time on earth or did you accomplish what you set out to do?  Are you proud of what you’ve accomplished?  Did you make others smile and bring happiness to those you met?

I believe in preventative medicine; yet sudden death seems to make a mockery of it.  My patient died much too young.  Would he have died sooner if he had not played by the rules?  I have to believe he would have.  I have to believe that taking care of your body adds years to your life.  I know that “an attitude of gratitude” adds quality to your life.

Stewart Segal is a family physician who blogs at Livewellthy.org.

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  • http://www.facebook.com/people/Debbie-Thompson/100000225773725 Debbie Thompson

    Please check into the Lyme Disease pandemic. Someone who looks healthy can be suffering in a big way, with this monster of a cocktail of infections. Thank you.

  • Dedangelo

    The illusion of control over a natural process – death – has rendered it an insult, with someone or something  to “blame.” It’s a peculiarly Western thought.

  • http://www.facebook.com/people/Constantino-Santos/1651600046 Constantino Santos

    We (all) are doing a great job in fighting disease and poverty (the two are tied …), including the fight by primary care, but life and death are not our core business. Life is a breeze, death ´s a sea of tranquility, the trouble is the transition :-)

  • DrGetWell

    Sudden Death makes a mockery of preventive medicine?Absolutely not!
    It is people who make mockery of themselves,while ignoring the possibility that sudden death is preventable
    Me,a retired phsician,discovered the secret.It is unfortunate that all my attempts to share it with academia ,so far failed.No boby listens to an old relic,except my patients.Boy do they get a bonus?Yes;
    this is the bonus of life with good cognition
    happy days are here again

  • hanover1

    Excellent article! Try to be as healthy as you can but make the most of everyday living with gratitude (I would say for your Creator and the blessings He provides). Man proposes, God disposes. Perhaps from a more limited scientific point of view the sudden deaths are the result of undiscovered health problems like a change in the propensity toward blood clots, etc. But man cannot know everything and doctors are not divine. Expecting them to be so is unfair and unrealistic.

  • http://www.facebook.com/people/Paul-Shepherd/824973233 Paul Shepherd

    As a victim of Sudden Cardiac Death (I was revived by EMTs and stabilized in an ER), I truly do live with attitude of gratitude for the miracle of my life.  I recognize that death is beyond my control or my physician’s control.  Yet I believe I survived partly because of my good physical condition and my efforts to live in a healthy way.  Thank you for caring.  From my perspective as a survivor, your blog reflects wisdom born from experience and its message resonates with me. 

  • http://www.facebook.com/people/Paul-Shepherd/824973233 Paul Shepherd

    As a victim of Sudden Cardiac Death (I was revived by EMTs and stabilized in an ER), I truly do live with attitude of gratitude for the miracle of my life.  I recognize that death is beyond my control or my physician’s control.  Yet I believe I survived partly because of my good physical condition and my efforts to live in a healthy way.  Thank you for caring.  From my perspective as a survivor, your blog reflects wisdom born from experience and its message resonates with me.

  • http://www.facebook.com/drjoe.kosterich DrJoe Kosterich

    Preventative medicine is about changing the odds. It is not a force field. Some things are in the “laps” of the gods and we are not to know the reasons

  • dlschermd

    While some sudden cardiac deaths cannot be foreseen, most of them can. The vast majority of sudden death arises in patients with previous heart attacks or other causes of decreased heart function. Evaluation of these patients with echocardiograms can prevent sudden death by identifying patients at risk (low ejection fraction) and getting them implanted with implantable defibrillators. That’s the flip side of this story because most patients who fall into this category of high sudden cardiac death risk never receive an ICD.

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