Ain’t the Way to Die by ZDoggMD

Great Job, Z!

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  5 comments for “Ain’t the Way to Die by ZDoggMD

  1. Pat
    August 7, 2015 at 12:57 am

    Talented as ever, Zdogg, but concrete enough for me not to even smile – it’s depressing, and we keep doing it. Just wrote my will and specified no feeding tube (though I may add an exception for a Jack Daniels, only). Brrr….

  2. Kurt
    August 5, 2015 at 9:11 am

    Major problem with this difficult topic is no matter how much time one takes to explain the situation to “certain” families, they expect “us” not to allow their
    loved one to die no matter what.

    I saw this as a real big problem 30 years ago in the big university hospitals. Who knows, maybe it’s still an issue today. I’ve had no exposure since I’m in a more rural area and many of the elderly I deal with are much more realistic and make their wishes known. This would have really hit home with me if I’d
    seen something like it in 1984. Beating a dead horse was really bad in those
    days at big institutions.

    I did see a new appellation on a university medical record that I really like.
    (I hate academic policy makers vehemently as a rule too) The term “DNI”
    or Do Not Initiate, seems more palatable to “DNR”. DNI means yeah, we’re were going to give comfort measures, use an antibiotic to attempt to treat the UTI or pneumonia in spite of the 10% ejection fraction but if the person dies we let them go. DNR after all these years stills sounds like “shove ’em in the corner to die”. Although for some situations that can be the merciful way.
    Sure, DNR/DNI is semantics but I finally found something politically correct that I like. Kurt

    • Sir Lance-a-lot
      August 5, 2015 at 10:37 am

      I thought “DNI” was “Do Not Intubate.”

      • Kurt
        August 6, 2015 at 2:30 pm

        Creeeeeeap, Lance! Me thinks you struck a mighty blow and are right on that. Me wrongo.
        I stand corrected but………..If one hasta to go through the motions, the poor resuscitated
        soul will need a vent so going “halfway” turns out to be a waste anyways.

        I like “Do Not Initiate” and it should be made part of the Lexicon. Kurt

        • Sir Lance-a-lot
          August 6, 2015 at 2:47 pm

          Yeah, Do Not Intubate came out, I believe, as a sneaky way around the “But you just can’t let Grandma die!” factor.

          Instead of going into all of the details of resuscitation, CPR, defibrillation, meds, intubation, vents, etc., which confuse the crap out of rational, competent people, and are like speaking Aramaic to debilitated patients and freaked out family members, you just say, “Remember last month when they had to put that tube down your throat, and it stayed in for a day? You don’t want that to be done again, DO YOU?
          Didn’t think so, could you sign here?”
          That way, in the event of the Inevitable, you have a very specific thing to say to the wild-eyed family members and long-lost relatives in the phone from across the country:
          Rather than going onto the ins and outs of what it means to “resuscitate” or “not to resuscitate,” you just say, “S/he said s/he didn’t want This One Thing, so we’re not doing it” (and, incidentally, not doing a few other things, either…).

          In the best of all possible words, I prefer “AND” or “Allow a Natural Death,” but that one can be a hard sell on some people, especially family members, and lacks the concreteness and specificity of DNI.

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