Feb 28 The Downside of Fighting

Our health care system is devoted to the heroic fight against death and disease. We have had many dramatic successes, particularly against infectious diseases, which lend themselves well to the fighting model. When we have an infection, foreign enemies, the bacteria, invade our bodies and cause the disease. We fight them off, chase them away, and the disease is gone.
But this model doesn’t work as well with chronic diseases. We can’t make them go away – we have to live with them. There are no invaders, so we end up fighting our own bodies. Long-term fighting is exhausting, both for the person with the disease and health care providers.
Our heroic fight against death has its downside also. We insist that people fight against dying and we praise those who never give up. But this means that when someone is dying they can’t acknowledge the truth. Very often the family won’t admit that they are dying, so they don’t have an opportunity to say goodbye or to get their affairs in order. If they are very unlucky their health care providers and even friends will avoid talking to them. After all, those who are dying have “lost the battle”.
It is not a problem that our health care system is able to fight. The problem is that we want to fight everything. We are fighting against death, a battle we will eventually lose every time.
We need to come up with a concept of health care that includes much more than fighting. And we need to admit that death is part of life and focus more on how to do it gracefully.