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Facing Life, Death, And The Limits Of Medicine

November 21, 2013
Written by: , Filed in: Breast Imaging, Diagnostic Imaging, Medical Ethics, Neuroradiology
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“How doctors die.” Quite the provocative headline.

It’s the title of a story, produced in partnership between the New York Times and the public radio show Marketplace, that was broadcast on the radio Tuesday and appeared in the newspaper on Wednesday. The piece takes a thought-provoking look at something that happens to physicians and laypersons alike: death. For both the print and audio versions, click here.

Marketplace senior reporter Dan Gorenstein profiles doctors with life-threatening diseases. He particularly examines how their knowledge of the limits and hazards of treatment affects their choices.

Elizabeth D. McKinley, MD, a 53-year-old internist from Cleveland, battled breast cancer for 17 years. The cancer metastasized to her liver and lungs, and tissue surrounding her brain. Dr. McKinley summarized her eventual treatment choices this way:

You can put chemotherapy directly into your brain, or total brain radiation. I’m looking at these drugs head-on, and either one would change me significantly. I didn’t want that.

She also didn’t want the side effects of radiation. “What Dr. McKinley wanted,” Gorenstein wrote, “was time with her husband, a radiologist, and their two college-age children, and another summer to soak her feet in the Atlantic Ocean. But most of all, she wanted ‘a little more time being me and not being somebody else.’ So, she turned down more treatment and began hospice care.”

Dr. McKinley’s mother didn’t understand the decision. Robert Gilkeson, MD, Dr. McKinley’s husband, said his mother-in-law pleaded with him to try another treatment—any treatment. “Dr. McKinley and her husband,” Gorenstein wrote, “were looking at her disease as doctors, who know the limits of medicine; her mother was looking at her daughter’s cancer as a mother, clinging to the promise of medicine as limitless.”

After her initial diagnosis, Dr. McKinley wrote and spoke extensively about patient care and end-of-life issues. In 2006, she created a blog, Saving My Life: One Poem at a Time.

“Since she stopped treatment,” Gorenstein wrote, “she was spending her time writing, being with her family, gazing at her plants. Dr. McKinley knew she was going to die, and she knew how she wanted it to go.”

Gorenstein’s story ends with this sentence: “Dr. McKinley died Nov. 9, at home, where she wanted to be.”

Related CME seminar (up to 39.25 AMA PRA Category 1 credits™): Comprehensive Review of Breast Imaging

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