Robert Martensen
Encyclopedia

Career and publications

Martensen has worked as physician in emergency room and intensive care unit
Intensive Care Unit
thumb|220px|ICU roomAn intensive-care unit , critical-care unit , intensive-therapy unit/intensive-treatment unit is a specialized department in a hospital that provides intensive-care medicine...

 settings and as a professor at Harvard Medical School
Harvard Medical School
Harvard Medical School is the graduate medical school of Harvard University. It is located in the Longwood Medical Area of the Mission Hill neighborhood of Boston, Massachusetts....

 and Tulane University
Tulane University
Tulane University is a private, nonsectarian research university located in New Orleans, Louisiana, United States...

, teaching bioethics
Bioethics
Bioethics is the study of controversial ethics brought about by advances in biology and medicine. Bioethicists are concerned with the ethical questions that arise in the relationships among life sciences, biotechnology, medicine, politics, law, and philosophy....

 and medical history
Medical history
The medical history or anamnesis of a patient is information gained by a physician by asking specific questions, either of the patient or of other people who know the person and can give suitable information , with the aim of obtaining information useful in formulating a diagnosis and providing...

. After Hurricane Katrina
Hurricane Katrina
Hurricane Katrina of the 2005 Atlantic hurricane season was a powerful Atlantic hurricane. It is the costliest natural disaster, as well as one of the five deadliest hurricanes, in the history of the United States. Among recorded Atlantic hurricanes, it was the sixth strongest overall...

, he moved to Maryland to work for the National Institutes of Health
National Institutes of Health
The National Institutes of Health are an agency of the United States Department of Health and Human Services and are the primary agency of the United States government responsible for biomedical and health-related research. Its science and engineering counterpart is the National Science Foundation...

 (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.

Views and experiences

In a 2009 interview with The New York Times
The New York Times
The New York Times is an American daily newspaper founded and continuously published in New York City since 1851. The New York Times has won 106 Pulitzer Prizes, the most of any news organization...

, Martensen said health care in the United States
Health care in the United States
Health care in the United States is provided by many separate legal entities. Health care facilities are largely owned and operated by the private sector...

 left many stakeholders dissatisfied. He said hospital administrators
Health administration
Health administration or healthcare administration is the field relating to leadership, management, and administration of hospitals, hospital networks, health care systems, and public health systems...

 were unhappy because they had to focus on profit, patients felt isolated, and some physicians were quitting because they could not practice medicine
Medicine
Medicine is the science and art of healing. It encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness....

 in the way they wanted.

Martensen criticizes end-of-life care in the United States. While most Americans die in nursing homes or hospitals, Martensen says 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 room, and in a hospital, a dying patient may be subject to intrusive medical technology
Medical technology
Medical Technology encompasses a wide range of healthcare products and is used to diagnose, monitor or treat diseases or medical conditions affecting humans. Such technologies are intended to improve the quality of healthcare delivered through earlier diagnosis, less invasive treatment options and...

 instead of palliative care
Palliative care
Palliative care is a specialized area of healthcare that focuses on relieving and preventing the suffering of patients...

 (which may result from the incentive
Incentive
In economics and sociology, an incentive is any factor that enables or motivates a particular course of action, or counts as a reason for preferring one choice to the alternatives. It is an expectation that encourages people to behave in a certain way...

s and disincentives in health insurance
Health insurance
Health insurance is insurance against the risk of incurring medical expenses among individuals. By estimating the overall risk of health care expenses among a targeted group, an insurer can develop a routine finance structure, such as a monthly premium or payroll tax, to ensure that money is...

 coverage).

Martensen has 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
Pacemaker
An artificial pacemaker is a medical device that uses electrical impulses to regulate the beating of the heart.Pacemaker may also refer to:-Medicine:...

. 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
Dysthanasia
In medicine, dysthanasia means "bad death" and is considered a common fault of modern medicine:Technologies such as an implantable cardioverter defibrillator, artificial ventilation, ventricular assist devices, and extracorporeal membrane oxygenation can extend the dying process.Dysthanasia is a...

) that can occur in hospitals, Martensen thought his father's death was relatively good. His father was 86, septic
Septic
Septic may refer to:* Septic tank, a component of a small scale sewage disposal system* Septic equation, a polynomial equation of degree seven* Septic shock...

, had deteriorating lung function, an advance directive with a DNR
Do not resuscitate
In medicine, a "do not resuscitate" or "DNR" is a legal order written either in the hospital or on a legal form to respect the wishes of a patient to not undergo CPR or advanced cardiac life support if their heart were to stop or they were to stop breathing...

, and he had started to receive morphine
Morphine
Morphine is a potent opiate analgesic medication and is considered to be the prototypical opioid. It was first isolated in 1804 by Friedrich Sertürner, first distributed by same in 1817, and first commercially sold by Merck in 1827, which at the time was a single small chemists' shop. It was more...

 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 (B.A.), Dartmouth (M.D.), and the University of California-San Francisco (M.A. and Ph.D.).
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