Wednesday, November 01, 2006

To care..

Go to Teresa's and Daran's blog ( and read about "Comfort care vs. Heroic care". Then come back here. Their insight leaves me humbled. I deal with the issues of "care" everyday, both comfort care and heoic care. Practicing pediatric critical care medicine embraces both. Children are admitted who are trying to die, or will die. Over the past 26 years or so of practicing critical care medicine, I have learned that "caring" is more than we give, and less than what patients receive. I am a medical ethicist, and deal with the issues of " care" over "cure", and life over death everday and here is what I've found: ask the following questions, and you'll begin to see what "caring" means:

1. do we "care" or "cure"?
2. are we treating the "patient" or the "disease"?
3. do we have a "contract" or a "covenant" with our patients?
4. is the technology we use a "necessity" or a "convenience"?

If we "care" rather than "cure", if we treat the "patient" (the person) and not the "disease", if we have a "covenant" and not a "contract" with our patients, and if we use technology because it is "necessary" for the patient, and not a "convenience" for us (we can attend to other things, personal things, "me" things, rather than being with the patient) then "caring" becomes central in our realtionship: it's about "who", not about "what".

Any one can "take care of " somebody: it's mechanics. But to "care about" and to "care for" somebody, takes self-sacrifice and intent to be there for someone regardless. "Heroic care" is that very "care" that Teresa and Daran are talking about: caring without bounds, loving always, giving freely. And Lord knows, they do it well...

In all things, give thanks,