Futility 

Futility 

What do I hope the outgoing FY doctors have learned after their time in surgery? For the surgical futured ones there are practicalities like tying a knot properly and closing the skin and inserting ports, as well as hopefully communicating with them the “hidden curriculum” of hard work, professionalism, kindness and care. The ones destined for general practice or other specialties. Someone much smarter than me wishes that they leave with foresight, insight and hindsight, which I love. 

One of the things I want them to leave with is how to recognise dying and manage it well. There are many phrases about knowing when not to operate being more important than when not to; same with ITU admissions and critical care beds. It is really hard to tell someone that they are dying, you can’t deliver it in the same way you tell them that their CRP is going up or down. It takes time and compassion and usually briefly takes a piece out of you emotionally. 

Do not avoid theses conversations, don’t prolong death with TPN and blood transfusions and pointless antibiotics. Do not shrink from your responsibilities and hide behind interventions and futile treatments. Recognise dying and help your patient and their family face it. It’s important. 

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