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On Being a Doctor - Of What Remains

Dr. Pyzer wonders, “Is it better or worse to know that something remains of our past once dementia robs us of our present?”

Use this essay to:

  • Listen to an audio recording, read by Dr. Michael LaCombe.
  • Do you “give up” on talking to patients with dementia. Why?
  • Why do patients' families continue to whisper into the ears of their comatose loved ones? Do we ever do this as clinicians? Why or why not? Do we feel silly doing so?
  • Have you ever witnessed a sudden expression of clairvoyance from a patient previously assumed to have lost all ability for organized or coherent thought?
  • At such a moment, Dr. Pyzer remarks, “We rejoiced, failing to appreciate how this revelation was a contradiction to our previous consolation; its implications for his continuing suffering; and how it ultimately highlighted the ever-present struggle to reconcile what we want for our patients, and for those left behind.” What does she mean? How does believing the “person” is no longer present console us as doctors? As family members? Might knowing there is still a “person inside” also make our jobs easier or more rewarding?

Annals of Internal Medicine is the premier internal medicine academic journal published by the American College of Physicians (ACP). It is one of the most widely cited and influential specialty medical journals in the world.

Back to the October 2019 issue of ACP IMpact