On a Serious Note

It's been a while since I wrote a serious post, so I decided to take a break from humor (I haven't updated in a month anyways). Today, as part of my Internal Medicine rotation, I shadowed a Palliative Care doctor for a day. Palliative Care is a division of medicine which deals with actively dying patients. The goal of PC is to find the balance between ending suffering and providing comfort, while still working towards prolonging life.

As part of the experience, I had to work through some online modules to teach me about the different aspects of PC. One of these modules dealt with "spiritual concerns," a common concern among dying patients. A section of the module had a list of Universal Spiritual Questions:

"When faced with a life-limiting illness, there are common questions/concerns of patients that transcend all religions, and cultures:

What is my purpose?
Does life have any meaning?
Why do people suffer?
Is suffering a punishment?
What is the meaning of death?
What happens after death?"

The last question made me pause. It used to keep me up at night. The thought of death didn't scare me half as much as that of an afterlife. I don't care how good an afterlife it is, I don't want eternity. But is nothingness a better alternative?

This is one of the comforts atheism has given me. That question no longer scares me. In fact, it doesn't even make logical sense to me anymore. What happens after death? That's like asking What color is honesty? Honesty doesn't have a color, and death doesn't have an after. Sure, time doesn't stop when I die. My friends and family go on living. But from my perspective, death is the end. The year 2200 will be the same to me as the year 1200. To quote Jim Jefferies, "I won't even know I'm dead. You wanna know why? 'Cause I'll be fucking dead!"

The sad thing about all this is how many people believe in an afterlife. I had a patient this morning, dying from metastatic prostate cancer, who is looking forward to reuniting with his father. I don't believe he will. The disappointment that he (won't) feel after he dies is utterly depressing to me. So depressing that I'm glad there won't be a moment of realization. But one thing I learned this morning is the importance of dying comfortably. And if that makes you comfortable, go ahead and believe it. Even if it is just a form of Pascal's Wager. Nothingness is much more comfortable for me.

"Although the time of death is approaching me, I am not afraid of dying and going to Hell or (what would be considerably worse) going to the popularized version of Heaven. I expect death to be nothingness and, for removing me from all possible fears of death, I am thankful to atheism." -Isaac Asimov

No God. Truth? Sham.

• I wonder how many crossbow deaths there were in Wisconsin last year?
• The most depressing thing I've seen this year in medicine: A 27-year-old grandmother.
  
• I wrote "radio beef" in my note pad. I have no idea what that was supposed to mean. If I remember, I'll update.
  
• Best bumper sticker I've ever seen: "Your child may be an honor student, but mine has more chromosomes!"
• In a couple months, swine flu will go the way of El Nino and SARS.
• Me "Mrs. P, even after your gastric bypass, you're still gaining weight. You still need to cut back on the snacks, and you should be drinking at least 60 oz. of water every day."
  Mrs. P "60 ounces?! Really? If I drink that much, I won't even be hungry!"
  Me "...yeah, that's kinda how it works."
  
• I had a patient named Jorge this morning. The resident pronounced it "Whore-gay." Good try...
• Later that day, the same resident asked a female patient her name. She said "Yvonne." The resident wrote "Ivan." Seriously, this person is a doctor.