I was rewatching an old video on YouTube and the guy was able to walk again after 10 months of practicing yoga and losing 140 lbs. If no one on earth can exactly predict when someone will die or if they’ll be able to walk again, how and why do doctors come up with these predictions?
https://youtu.be/qX9FSZJu448
In: Mathematics
ER doctor here. I can’t make great predictions on when someone will walk again, or how long they/ll live with a new diagnosis of cancer. But, I can pretty accurately predict how long you have left (minutes, hours, days) with one very important test called the Arterial Blood Gas. Its a blood test we obtain from the arterial blood and it gives us a data set of a few values, including blood pH, partial pressure of O2, partial pressure of CO2, and lactate level, among as few other things. I think my Respiratory Therapist friends can also attest, after you do this job for awhile and it becomes intuitive, these collection of numbers paint an overall picture on whether someone’s respiratory/metabolic compensatory processes are doing well, compensating, or failing.
The numbers mean nothing if you don’t know how to calculate and interpret them. In fact, most students/residents are able to correctly calculate them, but have trouble extrapolating that to a prognosis. At this point, I can quickly glance at the numbers and have a good idea if the patient in front of me is about to die if I don’t do something quick, will die no matter what I do, will make it through the night but will die in the morning, or can be stabilized, but will likely not maintain survivability over the next few weeks.
It seems like mumbo jumbo, but over time I am surprised by how accurate my guesses are. For example, one time an old man with shortness of breath had pristine vitals. Normal blood pressure, heart rate, etc. Looked well. The Arterial Blood Gas suggested he was likely to decline. In this instance, the he and the family opted for Comfort Care (no interventions as his cancer was very progressed). I told the family that, without intervention, he was likely to rapidly decline within the hour, and he would likely pass in about 2-3 hours. Like clockwork it happened exactly like that.
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