The physician-assisted suicide predicament

Physician
June 15, 2018

During the 1990s Dr. Jack Kevorkian drove his Volkswagen van through an unmet need in American medicine euthanizing 130 patients who felt death was the only solution to their suffering. He euthanized his “patients” with devices he named the “Thanatron” and the “Mercitron.” The former allowed his patients to administer IV barbiturates and potassium while to latter delivered carbon monoxide. When convicted of manslaughter, he told the court, “Dying is …

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The physician-assisted suicide predicament

Shakespeare on palliative care

Physician
June 8, 2018

In his lifetime, William Shakespeare wrote almost 120,000 lines and about 900,000 words. His 37 plays and 154 sonnets burnished his reputation as the unrivaled wordsmith of the English language. So what would the Bard, who had something to say about everything, have said about palliative care of the suffering of the sick? Although I couldn’t resurrect him from his venerated grave, I could unearth quotes from his collective works …

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Shakespeare on palliative care

Barbara Bush: The First Lady of palliative care

Physician
May 10, 2018

The “Great Man Theory” of history was popularized by the Scottish author Thomas Carlyle in the mid-19th century. In his 1840 “Lectures on Heroes,” he famously wrote: “The history of the world is the biography of great men.” Carlyle claimed that history was made by “great men” possessing personal courage, vision, charisma and political or military genius. Our more egalitarian age has favored mass movements, social forces and “great ideas” …

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Barbara Bush: The First Lady of palliative care

Palliative care is a right of all people in pain

Physician
March 24, 2018

In 2017, The Lancet published a report on the international lack of palliative care. It is a tale of woe documenting the sorry state of unrelieved global suffering. Everywhere “people live and die with little or no palliative care or pain relief.” It describes the “access abyss” in which the poor live and die in extreme suffering without receiving pain-relieving medications. They describe the world in …

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Palliative care is a right of all people in pain

A “stat” palliative care consult: cognitive dissonance meets cognitive ignorance

Physician
February 28, 2018

It was a perfectly comfortable morning when suddenly it was discomforted by a request for a stat palliative care consult. A stat consult is disquieting because “stat” is a dissonant adjective for the compound noun, “palliative care.”

“Stat” is the medical abbreviation for the Latin adverb “statim” meaning “immediately.” Stat orders always imply the necessity of an immediate response to an emergency: an inadequate blood pressure, an erratic hear rate, a …

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A “stat” palliative care consult: cognitive dissonance meets cognitive ignorance