In the Intensive Care Unit

Bill,

It's day 8 of my 10 day stint as the attending in the cardiac care unit. I was holding up pretty well until  today's admission to bed 8. She is a 90 year old severely demented non verbal lady who dropped dead after breakfast yesterday morning. She was subsequently resuscitated and brought by ambulance to the Emergency Room and then to my unit, where she now lies with a breathing tube down her throat, a catheter in her bladder and all the best (and most expensive) technology that 21st century American medicine can provide. And there she will stay until she dies, which she will likely do despite all of our efforts to prevent her from doing so. All at about 10 grand a day. There is no living will, no previous discussion with family  (where are those death panels when you need them?), There are many forms of torture that are less sadistic than what we are doing to this poor woman right now. This is American exceptionalism in its most bizarre incarnation-no one other country in the world allows its old folks to die as gruesomely and expensively as we do

This is where 25% of the Medicare budget is going. That is just nuts. But if the current election is teaching  any lesson to future candidates, it is that you mess with Medicare at your own political peril. Neither side is serious about doing anything to change this catastrophic state of affairs.

Good thing I only have 2 days to go. Otherwise I might run into this poor woman's family and give them a piece of my mind about how the hell they let this happen to someone they claim to love.

Eli