When I was a general surgery intern, I was doing my very early morning pre-rounds on a frail female patient in her late 70s with significant cardio- and peripheral vascular disease. She’d been in the hospital for weeks and wasted away to no more than 85-90 pounds. She was not able to get out of bed unassisted. I don’t even remember why she was in the hospital, but what I …
My parents were born on the same day, six years apart, Depression-era babies. My dad died on Christmas Eve, 2016. Nearly every Christmas season after that, for the next seven years, I hoped Mom would follow him.
Was I wrong to wish that?
Dad played Santa Claus for three decades, donning a suit that had belonged to his mother, along with her bearskin gloves and a set of sleigh bells. Eventually, he …
With Jimmy Carter’s passing, many will reflect on his impact at home and abroad. Yet, one his most personal acts will also stand as one of his most enduring legacies.
At 100, not only was our 39th president the longest-lived president, he was also to first to publicly elect hospice care, prioritizing the quality of his last days over simply being alive.
When he first enrolled two years ago, the family’s announcement …
Health care providers dedicate years to rigorous education and training to optimize medical care, aiming to heal and treat illness. However, historically, there has been a significant gap in training regarding the transition from a treatment-focused approach to focusing on providing comfort in the face of serious illness and death. This leaves health care professionals unprepared to navigate the complexities of end-of-life care. Despite their good intentions, health are providers …
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Join us as we welcome psychiatrist Lewis Cohen to discuss his book, Winter’s End: Dementia and Dying Well. In this episode, we explore the ethical dilemmas, legal challenges, and emotional impacts surrounding life-shortening …
During a recent palliative conference, the discussion turned to the challenges of translating our work to the public and our colleagues. Despite the growth of our field and increasing access, there remains major confusion about palliative care and hospice. Much of the misunderstanding originates from within the medical profession. Having worked in the palliative care and hospice arena for nearly two decades, I have seen many examples of the confusion …
We had been meeting for a number of months when she posed the question. We met in person one time, but other than that single appointment, all of our meetings were virtual. She had metastatic cancer. She didn’t actually want to know that her cancer had returned. The metastatic disease had been found when they couldn’t complete her colonoscopy and ordered a scan to see why. She helped me understand …
“Rejoin the natural cycle: to know that the last gesture you’ll make will be gentle and beneficial just feels like the right thing to do.”
– Recompose founder Katrina Spade
I love gardening and watching things grow, so I found the idea of human composting an intriguing concept. For those who find cremation unconventional or even unsettling, the process of disposing of the remains of a deceased loved one has taken a …
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Join us as we delve into the complex terrain of end-of-life care and the contentious debate surrounding assisted suicide legislation. Cardiologist Joseph E. Marine offers unique insights into the ethical, medical, and societal …
I opened my internal medicine practice almost four decades ago to serve a growing urban community. I gravitated toward the underserved geriatric population as they were vulnerable patients and eventually moved into the bygone realm of house calls for home-bound seniors.
This enhanced my learning curve, as house calls are not taught in medical school or residency yet bridge the continuity gap between hospitalization and patients returning home after an acute …
Are advance directives any better than they were four years ago when COVID was surging? Are patients still comfortable with being placed on ventilators? Do physicians better understand how to treat COVID as a serious illness?
Physicians provide emergency measures unless there’s an advance directive to the contrary. Only one-third of Americans have advance directives when “down for the count” with serious illness.
Most people prefer to die at …
Last month, the daughters of Wendy Miller, a 68-year-old author of three bestselling books about her experience with dementia, posted online her final words: “In the end, I died simply by deciding not to eat or drink anymore.”
Her stark statement reminded me of my interviews with Dan Winter, 62, which had begun nine months before he, too, took his own life. Alzheimer’s disease was slowly disassembling Dan’s rich and …
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I walk into the patient’s hospital room during evening rounds. He looks pale and tired, having recently completed a round of chemotherapy for his stage IV pancreatic cancer. His wife is at the bedside, scared and concerned about her husband’s rapid decline. I sit down to discuss goals of care when the patient immediately says, “I can’t do this anymore.” His wife responds immediately to the patient: “Of course you …
How do you make sense of someone dying? The only way I know is to put it into some context so that, if possible, some good can come of it.
Some of you may have known about my dad’s Parkinson’s disease. He’s had a fairly rapid decline over the past four months, and now he’s rapidly declining again. He has been on home hospice for the past three months. He has …
We all have those moments in medicine when we know that care has become more futile. Then we do everything in our power to educate, support, gently guide, and give permission to patients and families. There are moments that treating for a cure goes against our tenet to “first do no harm.”
I never would have imagined that I would be on the family side of these debates. I had a …
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At a time when many states are considering assisted suicide legislation, I was interested to encounter the perspective of the well-known bioethicist Arthur Caplan who recently expressed his support for these laws on these pages.
While I appreciate Caplan’s endorsement of protecting doctors’ ability to refuse, as a matter of conscience, to participate in assisted death, I admire his insistence on restrictions or safeguards within these laws to …
America expends much time, effort, and resources when people become seriously ill, bringing many face-to-face with their own mortality. For patients and their families, it is an emotional and difficult time under the best of circumstances. As a cardiologist, I participate in the decision-making that comes at this time, and it has provided me with the honor of delivering care that has allowed patients to rebound from acute illness and …
Kim Downey:
I recently had an enlightening conversation with Dr. Sarah Wittry. We enjoyed learning about all that we share in common!
As a physical therapist, I was delighted to hear that Dr. Wittry’s medical career began in physiatry/PM&R.
Having friends and relatives who have benefited from hospice care, I have tremendous respect for her current work in palliative medicine and hospice.
We spoke of how it has felt to each of us to …
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