- Are you ordering a routine colonoscopy on a 93 year old woman? Or a 30 year old man?
- Did you recommend surgery? Or no surgery? Or surgery A and not surgery B?
- Did you decide to order the $4000/month medication instead of the $40/month one?
- Are you recommending a mammogram for a 15 year old girl? Or an 89 year old woman?
- Did you send a patient out the door with a prescription for 250 oxycodone tablets? Or none?
- Do you want that person to come back in 3 days for a recheck? 3 weeks? 3 months?
- Did you recommend chemo? Hospice? Palliative treatment?
- Did you choose a ventilator for that patient? And comfort measures for that one?
- Did you recommend that thing for that entire group of people? And not that other opposite course of action?
Why? Because you are doing the best you can with the information you have in that moment. Because hopefully you have been given the gift of as much honest information as possible and you have all the tools you could ask for at your disposal to help someone make the best possible impossible decision for themselves or their loved one or their family or their entire community.
But why. For me, it all comes back to “but why.” It’s one thing to recommend a procedure, or write a prescription, or suggest a course of treatment, but it’s another thing, an all-together more important thing in my world, to be able to explain why. So before I make a recommendation that might affect one life or two lives or 5 lives or a million lives, I better understand why.
And if I were my own best friend, as I contemplate life-changing, life-rearranging, life-reaffirming decisions, I ask myself but why. But why did I make oatmeal raisin cookies instead of brownies? Because that is what I had the ingredients for, that’s why.