I am old enough to remember the thrill of the movie “The Great Escape.” Steve McQueen and his buddies are prisoners of war attempting an escape from a Nazi prison camp. Some of them make it to safety and some do not.
In the article “Dying at Home-Our Grandfather’s Great Escape,” Benjamin and Nicholas Chin-Yee, brothers and residents in a teaching hospital, tell the story of “breaking” their grandfather out of the hospital so that he could die comfortably and peacefully in his own home surrounded by his family. Cue the music. I had a similar experience in taking my own father home with hospice for his advanced Congestive Heart Failure. I had hoped that it wouldn’t have to be my idea; that I would not have to use my privilege as a physician to override the unhelpful but normal routine of the health care system.
The fact that we use the term “Escape” to describe having the option for comfort and support outside the hospital is depressing. It is only through the unique privilege of being a health care provider that the Chin-Yees are able to provide the kind of comfort and support that clearly their grandfather needed and wanted.
It doesn’t have to be this way. Working together we can create a healthcare system that we don’t have to escape from, that more people could be supported at the end of life, be out of the hospital if they desire and for those who need to be in the hospital, that their care is not causing iatrogenic harm. I look forward to a time when doing the right thing is the easy thing and not heroic.
Read the complete article in JAMA: