Saturday, March 14, 2009

When Patients Feel Abandoned By Doctors

http://www.nytimes.com/2009/03/12/health/12chen.html?pagewanted=2&_r=1&ref=health

The concept of the article is a sensitive one, and I think that the fact that it was written by an M.D. changed the way I read it. It uses first person and includes personal stories and assessments as well as "objective" ones.

The article is based off of a study of terminally ill patients and their caregivers and doctors, but this study only followed 55 patients. Not many details are given about the study--what percent of patients felt abandoned? The whole article builds off of the premise that this is a rampant problem, but there's not much support either way. In the personal example of Chen's patient John, she fails to communicate with the patient's family after his death. However, despite Chen's statement that closure "mitigates any feelings of abandonment," the story does not prove that. Chen doesn't include the reaction of John's niece--did this person crave closure and feel abandoned? The reader has no idea, and the story is poignant but not very effective towards Chen's point.

Dr. Back's quote about the two types of doctors is a good one. So is the one about patient death feeling like failure and looking for meaning. Despite the fact that he led the study about feelings of abandonment, I felt like this article lacked authority. There is a lot of speculation about why these feelings occur and how things can change, but it feels just like people guessing at causes and solutions.

At the end of the article, Chen finally mentions that this is a column, which was a surprise to me because the beginning presents itself as a news article detailing the results of a scientific study. The fact that it is a column doesn't change the fact that Chen didn't really support her assertion well. All I know now is that some number of patients, out of a study of 55, were somehow measured as having feelings of abandonment towards doctors. The article ends well, though, incorporating the visual picture of the ducks used earlier in the article.

1 comment:

  1. Even though this article had numerous problems, I enjoyed reading it. But I think that knowing it was a column did put a different spin on my opinion. I also started the paper reading it as an article, since it was written by a doctor. The study was not very concrete. I think the article would have been more effective it the story was about the study or about Chen’s personal experience with the topic.
    For me, the column lacked the terms of the study and the results. How did they follow the patients? Who did they discuss the abandonment with? How many people did feel abandoned? It feels like the author used the study to start the column, but the rest of the column was not really related to the study. She goes completely off track before she returns to the science aspects with abandonment. The article just seems poorly organized.
    The other path the author could have taken was to write about John. It’s a nice story, but it accomplishes nothing. Chen does not tell us who felt abandoned (like John or his niece). Chan tells her readers about the story to show us how friendly she was when caring for John, but she never really feels guilt for “abandoning” her clients. In her story, she has many frivolous aspects, as well. For example, no one cares that John found Chan by Googling select terms or that he was in a family of literary scholars. If she wanted to write about John, she should have written a short story, not a column.
    All in all, I think the article was poorly organized. Chan should have focused on one topic to write about, as opposed to writing many mini-stories that are not really alike. She only uses one source other than herself, so another source would have been helpful for a more unbiased article. I agree that she should have used John’s niece as a source. This would not only give readers an idea of how abandonment feels, but it would also show how Chan did decided to find closure with her patients.

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