Robert L. Martensen
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Robert Lawrence Martensen (January 1, 1947, Lake County, Ohio – September 26, 2013, Pasadena, California) was an American physician, historian, and author.


Career and publications

Martensen worked as physician in
emergency department An emergency department (ED), also known as an accident and emergency department (A&E), emergency room (ER), emergency ward (EW) or casualty department, is a medical treatment facility specializing in emergency medicine, the acute care of pati ...
and intensive care unit settings and as a professor at Harvard Medical School, University of Kansas Medical Center and Tulane University, teaching bioethics and medical history. After
Hurricane Katrina Hurricane Katrina was a destructive Category 5 Atlantic hurricane that caused over 1,800 fatalities and $125 billion in damage in late August 2005, especially in the city of New Orleans and the surrounding areas. It was at the time the cost ...
, he moved to Maryland to work for the National Institutes of Health (NIH) as the director of the Office of History. He was a recipient of a 2002 Guggenheim Fellowship towards the completion of his book ''The Brain Takes Shape: An Early History'', published in 2004 by Oxford University Press. In 2008, Martensen's book '' A Life Worth Living: A Doctor's Reflections on Illness in a High-Tech Era'' was published by Farrar, Straus & Giroux.Transcript
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Views and experiences

In a 2009 interview with '' The New York Times'', Martensen said health care in the United States left many stakeholders dissatisfied. He said hospital administrators were unhappy because they had to focus on profit, patients felt isolated, and some physicians were quitting because they could not practice medicine in the way they wanted. Martensen criticized
end-of-life care End-of-life care (EoLC) refers to health care provided in the time leading up to a person's death. End-of-life care can be provided in the hours, days, or months before a person dies and encompasses care and support for a person's mental and emotio ...
in the United States. While most Americans die in
nursing homes A nursing home is a facility for the residential care of elderly or disabled people. Nursing homes may also be referred to as skilled nursing facility (SNF) or long-term care facilities. Often, these terms have slightly different meanings to in ...
or hospitals, Martensen said neither are properly oriented to care for dying patients. In nursing homes, management may not want death to occur on-site, so the individual will be sent to the emergency department, and in a hospital, a dying patient may be subject to intrusive
medical technology Health technology is defined by the World Health Organization as the "application of organized knowledge and skills in the form of devices, medicines, vaccines, procedures, and systems developed to solve a health problem and improve quality of liv ...
instead of palliative care (which may result from the incentives and disincentives in
health insurance Health insurance or medical insurance (also known as medical aid in South Africa) is a type of insurance that covers the whole or a part of the risk of a person incurring medical expenses. As with other types of insurance, risk is shared among ma ...
coverage). Martensen discussed the end-of-life care of both his mother and father. While he was out of town and his mother was in the hospital, her physician called Martensen, saying she had a heart block and he asked if he should put in a
pacemaker An artificial cardiac pacemaker (or artificial pacemaker, so as not to be confused with the natural cardiac pacemaker) or pacemaker is a medical device that generates electrical impulses delivered by electrodes to the chambers of the heart eith ...
. Martensen, being a physician, knew which medical questions to ask, and he asked for a modest treatment. The issue was her fluids; after she was hydrated her EKG was normal. In Martensen's 2008 book, Chapter 7, "Life in the Narrows", discusses the death of his father. Instead of having a bad death (
dysthanasia In medicine, dysthanasia means "bad death" and is considered a common fault of modern medicine. Dysthanasia is a term generally used when a person is kept alive artificially, in a condition where otherwise they cannot survive; sometimes for some ...
) that can occur in hospitals, Martensen thought his father's death was relatively good. His father was 86, septic, had deteriorating lung function, an advance directive with a DNR, and he had started to receive morphine for air hunger. Alternatively, Martensen's father could have been put on a mechanical ventilator. However, that would have violated both Martensen and his father's wishes. Martensen explained that As the morphine began to act on Martensen's father, his anxiety from air hunger was lessening and he was still conscious. Martensen told his father he thought that life was slipping away, that he thought it was his time, that he loved him, and that was going to remove the oxygen; Martensen's father replied, "thank you."


Education

Martensen was educated at Harvard University (B.A., 1969), Geisel School of Medicine, Dartmouth (M.D., 1974), and the University of California, San Francisco (M.A. and Ph.D., 1993).


See also

* Futile medical care


References

{{DEFAULTSORT:Martensen, Robert American emergency physicians Harvard University alumni Geisel School of Medicine alumni University of California, San Francisco alumni Bioethicists American historians 1947 births 2013 deaths American male non-fiction writers