Recognizing and responding to a medical problem can be exciting and satisfying. For Death Foretold, sociology professor and physician Nicholas A. Christakis surveyed and interviewed scores of doctors across the United States. He concludes that predicting future outcomes is perhaps the most difficult and the least-appreciated job in modern medicine. A wrong answer here may disappoint a patient or embarrass the doctor. But more important is the emotional impact that any definite answer to this particular question carries.
Medical schools train doctors to think of death as the enemy.
Thus, a patient who dies is a personal defeat for his or her entire medical team. Consciously or not, Christakis argues, medical practitioners at all levels tend to reject death as an option. Even when convinced that a particular patient has little hope of recovery, physicians face a hard choice. If they express their pessimism openly, Christakis reports, many fear their statement will become a self-fulfilling prophecy, and the patient will simply accept their word and abandon hope. And should a patient recover in spite of a doctor's pessimistic prognosis, the doctor may be thought incompetent for failing to make an accurate forecast.