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Less Is More
October 2015

When Knowing More About a Patient Enables Us to Do Less

Author Affiliations
  • 1Department of Family Medicine, Oregon Health & Science University, Portland
JAMA Intern Med. 2015;175(10):1605-1606. doi:10.1001/jamainternmed.2015.4219

I recently went home to spend spring break with my 73-year-old father, who lived alone with emphysema. I had planned to discuss a move to assisted living; I had no intimation that this would, instead, be his last week of life. When I arrived, he could barely breathe. A few hours later, the emergency department physician and I had trouble finding any normal lung tissue on his computed tomographic (CT) scan. He was admitted to the intensive care unit (ICU) while receiving 15 L of oxygen, intravenous (IV) antibiotics, and steroids. When I asked how he felt about the bronchoscopy recommended by the pulmonologist—to “find out what was wrong”—I learned they had already attempted a “bronch” last week; it was aborted due to bleeding. This time, they would do the procedure in the operating room (OR) under general anesthesia. Dad said that he knew he might die in the OR, and that was okay with him.

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