At the Bottom of the Dog Pile

Football Pileup

Do you remember the game “dog pile”? The rules for the game are simple. A group of people pile on top of one person until the tower of people crumbles. Then everyone piles on top of the person who fell to the ground first and so on. I played it as a child. It resembles the professional game of football where people from the other team pile on top of the person with the ball; only they get paid millions of dollars to let people jump on them. (Yes, I know I’m simplifying it somewhat.)

The medical world also has terminology for something akin to this piling, crumbling mass of people; only it involves medical conditions instead of people. In the book, “Treat Me Not My Age: A doctor’s guide to getting the best care as you or a loved one gets older,” by Mark Lachs, M.D., he discusses a phenomenon called the geriatric cascade. He defines the geriatric cascade as: “One seemingly small event or medical misstep that leads to others, which in turn lead to others, until an irreversible spiral seems to have been set in motion.” Then, like smoldering embers these overlooked small events or missteps turn into an inferno.

You might wonder why it’s called it a geriatric cascade instead of simply a medical cascade. After all, I believe this is something that can happen to all people; not just geriatric folks. It seems reasonable that anyone receiving medical help could get caught up in this spiral of descending health and independence caused by a medical mishap or oversight.

If you have ever been at the bottom of a dog pile or caught in a downward medical spiral or geriatric cascade, you know how painful it can be. You also know how quickly the medical profession can fall from the high pedestal you’ve placed it on. Humans all make mistakes, but somehow we don’t think those in the medical profession should be allowed to. The stakes are high for the medical professional who makes a mistake compared to the clerk who gives you back incorrect change for your purchase. That doesn’t make them less human. At some point in life we all realize this; even if it’s at the end and there’s nothing left in that black leather bag to save your life.

Does it make it easier to take the world of medicine down from its illuminated pedestal before it falls off of its own accord? Perhaps. Perhaps it might make it easier to keep things in their true perspective all along; making the professional/patient journey easier for both parties.  Perhaps the rampant lawsuits would go away so medical professionals could focus on their jobs instead of their insurance. Perhaps the cost of health care would go down. Perhaps forgiveness instead of subpoenas could be extended to all humans and not just those outside the medical realm. Perhaps.

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