Skip to main content

Thoughts on Preventive Medicine


You can prevent Heart Attacks
You can prevent Strokes
You can prevent Colon Cancer
You can prevent Cervical Cancer
You can prevent Breast Cancer
You can prevent Prostate Cancer
Really? Well perhaps
You can prevent Syphilis
You can prevent the Friends of Syphilis
You can prevent smallpox, polio, measles, mumps, rubella, tetanus, chicken pox, meningitis, influenza, hepatitis, diphtheria, whooping cough
You can prevent Diabetes
You can prevent Complications of Diabetes
You can prevent Hip fractures
You can prevent Diarrheal Illness
You can prevent Nosocomial Infections
Really? Really, just wash your hands

But you cannot prevent death.
Saying that we can prevent death is preposterous.
Indeed, the word “prevention” doesn’t even apply to death
You can delay death
You can stall death
You can prolong life

But it just doesn’t make sense to say that you can prevent death.

Comments

Nice poetry. Any chance we might hear what spurred you on to write this? I hear a story in there somewhere.
Dan Matlock said…
No story, just a general frustration with our societal death denials and death taboos along with a frustration with applying the term prevention to the idea of death.
I had mentioned in a comment on Drew's recent post about acceptance and hope that our culture needs a modern revival of 'Ars Moriendi' which is really more about a different philosophical/spiritual approach to life and death and not about what medicine can or cannot do.

The book 'Republic of Suffering' is a great example of a major shift in how a culture views dying. It is about the American Civil War.
Alex Smith said…
Love the poetry! Thank you for branching out in new directions Dan.

Christian, a revival of the ars moriendi, "art of dying," is a good idea, but I'm not sure how this can be accomplished. So much of our culture is oriented toward "the science of not-dying," whatever that is in Latin. Also, I'm concerned that the idea of the "good death" may be a Christian (religion, not you personally) Anglo idea, and anathema to other cultures. In Chinese culture, for example, discussion of death is so avoided that even words that sound vaguely like death have negative connotations.

Popular posts from this blog

Practical Advice for the End of Life: A Podcast with BJ Miller

This week we talk with BJ Miller, hospice and palliative care physician, public speaker, and now author with Shoshana Berger of the book "A Beginner's Guide to the End."

As we note on the podcast, BJ is about as close as we get to a celebrity in Hospice and Palliative Care.  His TED Talk "What Really Matters at the End of Life" has been viewed more than 9 million times.  As we discuss on the Podcast, this has changed BJ's life, and he spends most of his working time engaged in public speaking, being the public "face" of the hospice and palliative care movement.

The book he and Berger wrote is filled to the brim with practical advice.  I mean, nuts and bolts practical advice.  Things like:
How to clean out not only your emotional house but your physical house (turns out there are services for that!)Posting about your illness on social media (should you post to Facebook)What is the difference between a funeral home and mortuaryCan I afford to die?  …

Caring, and the Family Caregivers We Don’t See

Over lunch at a restaurant in Manhattan, my father and I talked about long-term care insurance and the emergence of senior centers and nursing homes across the U.S. that offer a variety of ethnic cuisines and cultural events, catering not only to a growing population of adults over 65, but also, to an increasingly diverse population of adults who call the U.S. their home. This conversation was different from many similar ones before it – we weren’t talking about my research; we were talking about our own lives.
My parents immigrated to the U.S. in the late ‘70s and early ‘80s, following their parents’ advice on professional opportunities that seemed unimaginable in India at the time. Although they considered moving back soon after to care for their aging parents and to raise children, they ultimately decided to stay in the U.S. As I chronicled earlier, my paternal grandparents lived with us until I completed middle school, at which point they returned to India and lived with my mater…

Top 25 Studies in Hospice and Palliative Care (#HPMtop25)

by: Kara Bishoff (@kara_bischoff )

Back in 2015 we wrote a post asking for input on what articles should belong on a list of the top 25 articles in hospice and palliative care.   We decided to focus on hospice palliative care studies and trials - as opposed to review articles, consensus statements and opinion pieces.

Here’s what we came up with. It was hard to pick just 25! We highly prioritized clinical utility and tried to achieve diversity & balance. Many others are worthy of inclusion. Take a look and let us know if you have suggested changes for next year.

Module 1: Symptom Management
Randomized, Double-Blind, Placebo-Controlled Trial of Oral Docusate in the Management of Constipation in Hospice Patients. Tarumi Y et al. JPSM, 2013.Once-Daily Opioids for Chronic Dyspnea: A Dose Increment and Pharmacovigilance Study. Currow DC et al. JPSM, 2011.Effect of palliative oxygen versus room air in relief of breathlessness in patients with refractory dyspnoea: a double-blind, randomise…