Stop

Sitting in her hospital room yesterday while my wife slept, I occupied myself with my smartphone, playing word games and reading snippets of the day’s news. “The news.” The words suggest factual information, but hidden within them are layer upon layer of bias. Regardless of the media outlet, reporters and writers and editors busily craft messages that cleverly convey a soft chauvinism; opinions disguised as data. I suspect most of the people who manipulate their messages are guilty only of what they consider defensible prejudice; progressive perspectives on one end of the spectrum, conservative outlooks on the other. Regardless of the relative merits of their opinions, though, they are engaged in subtle (or not-so-subtle) attempts to sway media consumers’ thinking in support of specific viewpoints. Editorial pages once were reserved for such endeavors. Today, it seems editorials and raw reportage have merged into a form of propaganda. Not “fake news,” but predigested information. I try to find information untouched by presentation bias. It’s rare. A few media outlets, like the Associated Press and, to a lesser extent, the News Hour on PBS, seem to work diligently to remove bias from their reporting of the news. Most, though, no longer even attempt to hide their bigotry.

The news media is not alone in its innate biases, the ones that arise from philosophies of life that guide beliefs and behaviors. I think medicine, too, is rife with opinions that sometimes masquerade as facts. I am more forgiving of medicine’s opinions, though, because usually they seem to be guided by carefully evaluated experiences, coupled with (almost) universally accepted facts. Still, though, doctors present patients and their families with options filtered through the lens of the physicians’ experiences. I prefer hearing doctors’ specific options as recommendations, rather than as menu items, all of equal merit. That is, I want to hear a doctor to say, “Based on the options available to you, if I were you I think I would…” The recommendations can be argued and questioned, but the doctor’s point of view is clear.

That was true yesterday when the medical director of the hospice suggested my wife be moved to inpatient hospice care, versus being discharged from the hospital for home hospice care. My gut tells me the doctor could read the fear in me, fear that I would be unable to provide the quality of care that would ensure my wife’s comfort. In recognizing my concerns, he assessed the situation as one in which a recommendation from a physician was warranted. He clearly felt inpatient hospice was preferable, given the circumstances. And he said the decision could be reversed at any time my wife and I felt it appropriate. And, of course, he and his team could determine if my wife were no longer qualified for inpatient hospice care, in which case we could opt for home hospice, palliative care, or traditional home health nursing services.

For me, the difference in bias between news organizations and physicians comes down to accountability. News organizations can retract comments or stories and can explain how changes in the external environment can influence the reliability of “facts.” Doctors, though, tend to qualify their recommendations (biases) before making them; not after the fact.

I arrived at the hospital yesterday morning around 7:30. My wife was fast asleep. An untouched tray of food sat on the overbed table. When a nurse came in a while later to administer some medications, my wife roused briefly but did not open her eyes. She expressed with a shake of her head that she did not want to take medications and that she wanted to be left alone. A couple of hours later, the tray of food was removed and, later still, another tray was brought in. My wife remained asleep. It was not until about 2:30 that she opened her eyes and communicated with me, mostly with whispered words and barely-noticeable gestures. She was thirsty and hungry. I gave her tea. She ate an entire helping of penne pasta with meat sauce and made quite a dent in a scoop of whipped potatoes. Then, she went back to sleep. It was during those hours of sleep that the doctor spoke to me and made his recommendations.

My wife was moved to inpatient hospice around 4:00 pm. Not long after she was settled in, another plate of food was brought in to her and I helped her with the chicken and potatoes.  I left for home around 5:30.  I can visit her again this morning beginning at 9. If I leave after 8 this evening, I will have to exit through the emergency room. But I can stay overnight, if I wish and my wife is agreeable, sleeping in what I know to be a beastly uncomfortable chair. I suspect I can manage it, though, with pillows. I know I need to get things done around the house, but I may opt to stay there on occasion, if for no other reason than to let my wife know I’m there.

I’ve wandered away from a topic I hoped would distract me. I tend to do that. I guess I’ve always wanted or needed to be distracted from life itself but have, so far, failed to stay the course.

The clothes in the dryer will be ready soon and my coffee cup is in need of a refill. Good time to stop.