Getting Medicine Back on Track
Dr. Topol: How do we get it on track?
Dr. Snyderman: We have to talk about the fact that life is finite. We as Baby Boomers really still think of death as optional. We really don't have those hard conversations. We've had them in my family, and my kids know what I do and don't want. I think you have a responsibility to your adult children to talk about how you want to own your life in good health and in bad so that they have parameters. But we don't have those conversations until there's a crisis, and then everybody has an opinion except you, and you lose control. I was in San Francisco at the height of the AIDS epidemic, so I got to watch gay men know that they were going to die and they dealt with it. They planned their lives as a celebration, they told people what they wanted them to have out of their belongings, and they talked about death as a necessary transition out of here to make room for other people. I thought that in those years we might alter how we talk about death and dying in the United States, but we didn't grasp it. The rest of the population didn't grasp it. I think that's a lost opportunity.
Dr. Topol: And as you're already pointing out, how much of these resources are consumed by that last phase of life.
Dr. Snyderman: If you're 92 and you suddenly have a colon cancer, do you want to be intubated on a ventilator and get chemo? I don't. I want to be in my own bed in my house, with great linens, and my dog in my bed next to me -- and, frankly, someone near me who can push morphine. I want to own that, but I want to give people the okay to keep me comfortable and not think that they're doing me a favor by doing something that has no value to it. A good, long life lived matters to me. But a long life of suffering or not being me, I have no interest in that.
Dr. Topol: It has really been great to get your views and unique perspectives. You're about the most perky, bubbly person; when I looked those words up in the dictionary I think I see your picture. But it's been nice to get some insights; I have not discussed a lot of these things with you before. And it's great for the Medscape community to hear a lot of your thoughts and learn about this really illustrious and unique parallel career you've had, as a woman and a surgeon working in medicine and media.
Dr. Snyderman: That's what makes medicine so great. Where else would a cardiologist and an otolaryngologist get to not only learn about each other's fields but become friends? And it's a friendship I don't take lightly. It's a real treat for me.
Dr. Topol: I want to thank all of you for tuning in to Medscape One-on-One with Dr. Nancy Snyderman and me.