November 27, 2019
JAMA Cardiol. Published online November 27, 2019. doi:https://doi.org/10.1001/jamacardio.2019.4545
Many people liken the field of heart failure to oncology. Both fields treat a heterogenous group of diseases simplistically referred to as heart failure or cancer. Both share the extremes of victory and loss. Both offer an opportunity for intense patient-physician bonds that are sometimes counterbalanced by difficult end-of-life conversations. Both sometimes force us to engage in uncomfortable discussions about the ineffectiveness of our modern medicine in treating certain diseases. And both offer a unique insight to the questions that dying individuals have to confront, sometimes alone.
I have always been fascinated by the convergence of literature and medicine. Leo Tolstoy’s classical piece, The Death of Ivan Ilyich, is one that never ceases to amaze me in its timeless portrayal of the dying process. Over the years, I have encountered many parallels between some of my patients and the fundamental drama Tolstoy paints through his satirical prose in which the main character, Ivan, is suddenly transformed from a healthy man to a dying one with a frustratingly unclear diagnosis. I have had many patients who share this story. There are certain patients who leave their legacy with you either because of their fascinatingly rare diagnosis, the unpredictable course of their illness, or their path towards end of life. Sometimes all three.
My patient was an otherwise healthy male in his early 60s who loved basketball and jazz and who immediately swept us away by his force of personality. He was admitted with new-onset heart failure, and unfortunately his hospital course quickly became rocky, commencing early on with extracorporeal membranous oxygenation. He seemingly transitioned from health to disease in a mere instant like Ivan in Tolstoy’s tale. His spiraling health was perplexing until finally the etiology of his heart failure became clear and he was diagnosed with multiple myeloma-associated light chain amyloidosis, a cancer and a heart disease formidably packaged in 1 diagnosis./.../
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Leo Tolstoy | Russian writer | Britannica
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16 de nov. de 2019 - Leo Tolstoy, Russian author, a master of realistic fiction and one of the world's greatest novelists. Tolstoy is best known for his two longest ...
