Vignettes of a South African Township called Mdantsane

Sunday, April 3, 2016

Communicating, Death or Dying in the Emergency Department, What is correct and what is wrong

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There are correct and incorrect communication practices but the core word here is not practice but communication. In a vastly digitalized globalised world, communication in the oral form is getting minute more than before. Let’s just go back, maybe reverse to even 30 years, when oral communication was the major route to understand, involve and evolve. So how have things changed now and has it changed because the environment has changed the circumstances of communication.

As I sit to answer this question, my personal experience reverts back to me. Death and dying have always been combated with humility, respect and understanding, relationships and bonds are forged and time loses its existence during such moments. We were never taught communication tactics as it came to us naturally from the very beginning as a group involving with medicine. A millennium before Hippocrates, the Indian Vedic texts of Shusrut called for respect for patients and fellow physicians, irrespective of color class and creed. We have come to a stage now where we are questioning ourselves, what is reasonable and what is not in presenting death and dying in a formidable form.

Yet in this very narrow quest for reasoning in an entirely new world, death and dying have suddenly become economics, pawns in unknown hands. Futility is being questioned, re-    questioned and answered in qualitative and quantitative proportions. Death occurring in unreasonable circumstances, in war and poverty seem now far more reasonable and defy questioning.

Ayan Rand’s monumental work, Atlas Shrugged brought the western society to understand reasoning and in turn tried reasonable means to communicate sadness and grief which turned to be abject failure.

Legalities in communicating death by set standards of behavior and words became protocols to be followed in Emergency Medicine departments. The relative term in explaining and understanding death and dying in the sociocultural context, geopolitical means and the individual physician’s attempt within such environments remains viable. In this twenty-first century which is seeing the rise of Artificial Intelligence, its growing importance in our daily lives including Medicine, communication will continue to respect and realize, not in words expressed but thoughts traversed by mere touch of human hands. The fall of a physician’s eyelid in the presence of close ones will signify the war lost and respect for the mortal being stretched in momentous proportions.

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