I live across the street from a funeral home. Each day as I see the cars begin to line up and the people in dark clothes gather to say goodbye, I can’t help but wonder about the stories inside. Who were they coming to honor? What kind of life had just ended? So, most mornings, before I check my email or the hospital census, I read the obituaries.
As a child, …
For the past century, physicians have practiced within the framework of materialism: the belief that everything real can be measured, and everything measurable is real. But that worldview has been quietly eroded by physics itself. In the double-slit experiment, particles behave as waves of probability until observed, at which point they collapse into definite form. Later variations (such as Wheeler’s delayed-choice experiments) demonstrated that observation seems to determine not only …
For nearly a decade, almost every time my husband, Teddy, went into the hospital, they asked if he had an advance directive. And he did: It was notarized and given to any doctor he saw and any hospital he visited, including the one he died in.
But on the last day of Teddy’s life, the interventions he received were explicitly against his wishes as documented in his advance directive: no resuscitation, …
“Health-care professionals are increasingly demoralised by pressure to prioritise their employers’ financial goals over patients’ needs and professional norms, as space for good work in a bad system narrows.” This statement from an October 2025 Lancet article spoke directly to my experience.
By all quantifiable metrics, I was successful. I’d just been promoted to associate professor in the number-one-ranked department in the country for my specialty. I had a rewarding leadership …
AI is rolling out in medicine faster than most of us can process. Ambient scribes documenting visits. Clinical decision support algorithms. Automated prior authorizations. The promises are compelling: reduced clerical burden, more face-time with patients, less burnout.
I wanted this. As a palliative care doctor and director of physician well-being at my institution, I’ve spent years watching colleagues drown in documentation and burn out from relentless task loads. When AI tools …
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Physician executive Joseph Pepe discusses his article, “A doctor’s guide to preparing for your death.” He shares practical and compassionate advice on planning for life’s inevitable end, from organizing essential documents and …
Extreme longevity
People claim they want to live to be 100, yet is that a good thing? How you get there may make all the difference. Here’s my take on Blue Zones and the prospect of living to 100. “Blue Zone” is a nonscientific term popularized twenty years ago by Dan Buettner, a National Geographic explorer who studied five geographic regions where many people live to be over ninety or 100. …
Let us get this straight: Enjoying life is amazing. You should do more of it. Every day, if you can. But if you are truly committed to living well, you also need to get comfortable with something most people avoid like mystery meat at a buffet: preparing for your death.
Not obsessing over it. Not fearing it. Just preparing, so your loved ones are not left trying to solve your digital, …
As doctors, we often tend to focus on solving the problem at hand. We identify the issue, make a diagnosis, and try to treat the condition to the best of our capabilities. And in this pursuit to achieve our textbook level of homeostasis, we often forget that it is the patient who requires us. As rightfully pointed out in the posters outside the palliative care center, sometimes we may encounter …
The first thing I remember is the sound of oxygen at night.
It was my second week as a hospice nurse. I had just pulled up to a modest home on a cul-de-sac, the kind of place where wind chimes echo off empty sidewalks. Inside, a man in his seventies was dying of end-stage pulmonary fibrosis. He was surrounded by family, but it was that soft hiss—steady and rhythmic, like an …
We’ve medicalized nearly everything in life—birth, aging, sleep, even boredom. Now, in the spirit of efficiency, we’ve begun medicalizing death itself.
In his unsettling essay “The European way to die,” French novelist Michel Houellebecq warns that the normalization of euthanasia and assisted suicide is not a sign of progress but of profound cultural decay. I didn’t expect to find myself agreeing with him.
As a physician for over three decades, I’ve …
“This is Dr. Mohr.” I answered a number I didn’t recognize.
“It’s Irving,” said the frantic voice. “He collapsed. The paramedics are working on him now.”
“They’re doing compressions? Stop! Put the paramedic on the phone!”
My father-in-law, Irving, the stoic Danish-American Navy veteran, had been on hospice for 3 months. His POST (physician order for life sustaining treatment) form was on file with the hospice agency and his custodial care facility: DNR/DNI, …
Recently, researchers examined whether there had been any changes in the way terminal cancer patients died from 2014 to 2019, given the increased information available on hospice, palliative care, and advanced end-of-life planning (EOLP). They asked whether those who were terminal continued aggressive treatment until their demise. The authors anticipated a decrease in this, but found that the frequency of cancer patients who continued aggressive therapy had not declined. The …
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“It is a sad state that fear of liability will oftentimes negate the moral choice made by a terminally ill patient.”
– Journal of Air Law and Commerce
Background
In August 2024, I gave a presentation, “You’re suing me because I kept your mom alive? Avoiding wrongful life lawsuits.” I discussed the consequences for medical staff when they disregard a valid DNR and revive a person, against their wishes. There are numerous nationwide …
It’s not the easiest question to ask aloud—especially in medicine, where we pronounce death but rarely reflect on it.
We chart it. Certify it. Explain it.
But what does it mean to die?
For most of us, the word carries a double weight. It means to stop biologically. To cease. To end.
But it also means to vanish. To be forgotten. To be no longer seen, needed, or named.
As a surgeon, I saw death …
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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