Clipping Board » Medical Myths ─ The truth about healthcare is often different from what you intuitively think.
Newtalk June 24, 2012
Reported by Lin Chaoyi, Taipei
Regarding the philosophy of life and death, Dr. Ko Wen-je, a surgeon at National Taiwan University Hospital, said in a speech today (24th), "What is death? What does it mean to be alive?" Many ineffective medical treatments are merely "performed to show effort and avoid lawsuits." Doctors, he noted, are not trained in the philosophy of life and thus often don’t know how to tell families when a patient is beyond saving.
Dr. Ko was invited by the Huayen Society to deliver a lecture titled "The Four Seasons of Life," sharing his views on existence. He cited the Buddhist story of Kisa Gotami to illustrate that death is inevitable. After losing her son, the widow Kisa Gotami sought the Buddha’s help to revive him. Only after visiting every household in the city did she realize that no family had been spared from death.
Ko said his life philosophy is to "play chess in his own style." "If you always listen to others’ opinions or govern by reading newspapers, you’ll keep changing every day." At this point, the self-proclaimed "deep green" supporter suddenly paused and said, "Never mind, I shouldn’t speak ill of others," drawing laughter from the audience.
He also joked about himself, saying that becoming a doctor was his father’s decision, getting married was his mother’s choice—because parents know their children best and won’t harm them. The number of children to have was his wife’s call, and specializing in critical care medicine was decided by Professor Zhu Shu-xun.
He never wanted to perform surgeries, so he became a "super relief pitcher." Among those who graduated from NTU’s College of Medicine in 1986, only two pursued surgery, which explains the "four major shortages" in medical fields. The decline began 20 years ago; today, it’s just a full collapse.
Having spent years in the ER, Ko urged the audience to ponder: "What is death? What does it mean to be alive?" He said that regardless of whether life is black-and-white or colorful, the end (the corpse) only comes in three colors: black, yellow, or white. Life is merely a process because it has no inherent purpose. Since it’s a journey, don’t carry too much baggage. As the Buddhist sutra says, "Once you reach the shore, leave the boat behind." You must let go and keep transcending.
During the lecture, Ko showed several photos to demonstrate how modern medicine sustains life. These included artificial hearts developed or imported by NTU Hospital, costing hundreds of thousands or even NT$4.5 million, with backup batteries to prevent heart failure.
He joked that since the introduction of ECMO (extracorporeal membrane oxygenation), Taiwan’s most famous doctor has been "Dr. Ye" (a play on ECMO’s Chinese name). The longest recorded survival on ECMO in Taiwan is 117 days, while the longest unsuccessful attempt lasted 180 days. Globally, the longest CPR revival is "Little Wei," who survived after four hours.
But Ko pointed out that modern medicine is a high-tech jungle. "The question is, how much are you willing to pay to extend life?" He urged reflection: beyond the machines, what remains? With artificial hearts, lungs, and livers, patients won’t die as long as the machines keep running. But if the machines are removed, can they still be considered alive?
Ko then showed photos of a child whose legs turned black after three days on ECMO—amputation was the only way to save his life. The child survived but lost both legs. Another 7-year-old on ECMO had all four limbs blackened. The family refused amputation, and the child passed away the next day.
He asked, where is the line between life and death? One ECMO patient remained fully conscious, watching his lower body slowly die—something unimaginable in the past. This led Ko to support amendments to the Hospice Palliative Care Act, allowing families to decide on withdrawing life support and letting patients pass peacefully.Ko Wen-je said there is a lot of ineffective medical treatment. At National Taiwan University Hospital, a high proportion of patients are still undergoing dialysis or X-rays on the day they die. He stated that Taiwan’s medical education does not teach doctors about the philosophy of life, nor how to communicate with patients’ families. "No one teaches doctors what to do when a patient cannot be saved." As a result, from top to bottom, including nurses, everyone knows the patient cannot be saved, but no one knows how to tell the family.
He also mentioned several celebrities who were essentially already gone, and the ECMO had been removed. But because the president was about to visit, the ECMO was reattached, and the hospital director was coming too, so it couldn’t be taken off.
He shared another story from NTU Hospital’s 7D intensive care unit. A distressed family member brought their father, who was in the late stages of cancer and struggling to breathe, to the emergency room. However, neither oncology nor internal medicine would admit him, so he was eventually sent to surgery. The surgeon at the time complained about having to write reports for admissions and deaths.
Ko Wen-je said that four hours later, the father passed away. When his body was being taken to the morgue, his daughter knelt down by the nursing station and said to the nurse, "Thank you for not letting my father die in the emergency room hallway." After that, the complaining surgeon didn’t speak for half a day.
Ko noted that in the more than two years since the 7D ward was established, there have been almost no complaints. Good end-of-life care and respect for life naturally reduce medical disputes. The only complaint came from a family member who had never visited the patient in the hospital.
He said one reason doctors lose their passion is the excessive hostility in Taiwanese society, including the blue-green political divide. One doctor, after saving lives upstairs, went to the emergency room only to have a family member immediately pull out a voice recorder to question why he took so long. After one or two incidents like this, the doctor’s enthusiasm was gone.
When asked why hospitals still perform CPR on patients they know cannot be saved, Ko Wen-je said it’s due to a lack of mutual trust between people, so they "resuscitate just to show you, afraid of being sued."
He gave the example of European buses, where card readers are placed in the middle of the bus. People swipe when boarding or exiting, with no one monitoring. But in Taiwan, the card reader is next to the driver, who watches. A society operates most efficiently when there is mutual trust, but Taiwan’s biggest problem is that everyone is on guard against each other.
He urged the audience to think carefully about whether to sign a "Do Not Resuscitate" (DNR) order when they go home. Make the decision early, so as not to leave the difficult choice to their children later.
Source: http:/ / tw. news. yahoo. com/ % E6……5% B0% E5% BB% 8A- 131636920. html
Ko Wen-je: Daughter Kneels to Thank Nurses for Saving Father in ER
Reported by Lin Chaoyi, Taipei
Regarding the philosophy of life and death, Dr. Ko Wen-je, a surgeon at National Taiwan University Hospital, said in a speech today (24th), "What is death? What does it mean to be alive?" Many ineffective medical treatments are merely "performed to show effort and avoid lawsuits." Doctors, he noted, are not trained in the philosophy of life and thus often don’t know how to tell families when a patient is beyond saving.
Dr. Ko was invited by the Huayen Society to deliver a lecture titled "The Four Seasons of Life," sharing his views on existence. He cited the Buddhist story of Kisa Gotami to illustrate that death is inevitable. After losing her son, the widow Kisa Gotami sought the Buddha’s help to revive him. Only after visiting every household in the city did she realize that no family had been spared from death.
Ko said his life philosophy is to "play chess in his own style." "If you always listen to others’ opinions or govern by reading newspapers, you’ll keep changing every day." At this point, the self-proclaimed "deep green" supporter suddenly paused and said, "Never mind, I shouldn’t speak ill of others," drawing laughter from the audience.
He also joked about himself, saying that becoming a doctor was his father’s decision, getting married was his mother’s choice—because parents know their children best and won’t harm them. The number of children to have was his wife’s call, and specializing in critical care medicine was decided by Professor Zhu Shu-xun.
He never wanted to perform surgeries, so he became a "super relief pitcher." Among those who graduated from NTU’s College of Medicine in 1986, only two pursued surgery, which explains the "four major shortages" in medical fields. The decline began 20 years ago; today, it’s just a full collapse.
Having spent years in the ER, Ko urged the audience to ponder: "What is death? What does it mean to be alive?" He said that regardless of whether life is black-and-white or colorful, the end (the corpse) only comes in three colors: black, yellow, or white. Life is merely a process because it has no inherent purpose. Since it’s a journey, don’t carry too much baggage. As the Buddhist sutra says, "Once you reach the shore, leave the boat behind." You must let go and keep transcending.
During the lecture, Ko showed several photos to demonstrate how modern medicine sustains life. These included artificial hearts developed or imported by NTU Hospital, costing hundreds of thousands or even NT$4.5 million, with backup batteries to prevent heart failure.
He joked that since the introduction of ECMO (extracorporeal membrane oxygenation), Taiwan’s most famous doctor has been "Dr. Ye" (a play on ECMO’s Chinese name). The longest recorded survival on ECMO in Taiwan is 117 days, while the longest unsuccessful attempt lasted 180 days. Globally, the longest CPR revival is "Little Wei," who survived after four hours.
But Ko pointed out that modern medicine is a high-tech jungle. "The question is, how much are you willing to pay to extend life?" He urged reflection: beyond the machines, what remains? With artificial hearts, lungs, and livers, patients won’t die as long as the machines keep running. But if the machines are removed, can they still be considered alive?
Ko then showed photos of a child whose legs turned black after three days on ECMO—amputation was the only way to save his life. The child survived but lost both legs. Another 7-year-old on ECMO had all four limbs blackened. The family refused amputation, and the child passed away the next day.
He asked, where is the line between life and death? One ECMO patient remained fully conscious, watching his lower body slowly die—something unimaginable in the past. This led Ko to support amendments to the Hospice Palliative Care Act, allowing families to decide on withdrawing life support and letting patients pass peacefully.Ko Wen-je said there is a lot of ineffective medical treatment. At National Taiwan University Hospital, a high proportion of patients are still undergoing dialysis or X-rays on the day they die. He stated that Taiwan’s medical education does not teach doctors about the philosophy of life, nor how to communicate with patients’ families. "No one teaches doctors what to do when a patient cannot be saved." As a result, from top to bottom, including nurses, everyone knows the patient cannot be saved, but no one knows how to tell the family.
He also mentioned several celebrities who were essentially already gone, and the ECMO had been removed. But because the president was about to visit, the ECMO was reattached, and the hospital director was coming too, so it couldn’t be taken off.
He shared another story from NTU Hospital’s 7D intensive care unit. A distressed family member brought their father, who was in the late stages of cancer and struggling to breathe, to the emergency room. However, neither oncology nor internal medicine would admit him, so he was eventually sent to surgery. The surgeon at the time complained about having to write reports for admissions and deaths.
Ko Wen-je said that four hours later, the father passed away. When his body was being taken to the morgue, his daughter knelt down by the nursing station and said to the nurse, "Thank you for not letting my father die in the emergency room hallway." After that, the complaining surgeon didn’t speak for half a day.
Ko noted that in the more than two years since the 7D ward was established, there have been almost no complaints. Good end-of-life care and respect for life naturally reduce medical disputes. The only complaint came from a family member who had never visited the patient in the hospital.
He said one reason doctors lose their passion is the excessive hostility in Taiwanese society, including the blue-green political divide. One doctor, after saving lives upstairs, went to the emergency room only to have a family member immediately pull out a voice recorder to question why he took so long. After one or two incidents like this, the doctor’s enthusiasm was gone.
When asked why hospitals still perform CPR on patients they know cannot be saved, Ko Wen-je said it’s due to a lack of mutual trust between people, so they "resuscitate just to show you, afraid of being sued."
He gave the example of European buses, where card readers are placed in the middle of the bus. People swipe when boarding or exiting, with no one monitoring. But in Taiwan, the card reader is next to the driver, who watches. A society operates most efficiently when there is mutual trust, but Taiwan’s biggest problem is that everyone is on guard against each other.
He urged the audience to think carefully about whether to sign a "Do Not Resuscitate" (DNR) order when they go home. Make the decision early, so as not to leave the difficult choice to their children later.
Source: http:/ / tw. news. yahoo. com/ % E6……5% B0% E5% BB% 8A- 131636920. html