Palliative Care
Medical aid in dying: time for evidence-based legislation
Medical aid in dying (MAID) is poised to be one of the hottest political health care issues of 2024. As in 2023, more than a dozen states will hold both impassioned hearings in legislative chambers and equally fervent debates in the community. Already, nearly twenty states have introduced bills to authorize MAID this year. They seek to join the eleven states that already authorize MAID for 73 million Americans (California, …
Breaking the silence on caregiver stress [PODCAST]
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Join R. Lynn Barnett, a patient advocate. We’ll explore the world of caregiving, its challenges, and the profound impact it has on individuals and families. Discover valuable insights on caregiver stress, self-care, and the importance of respite …
Palliative care and the garden of hope
My grandmother had a beautiful garden that she expanded through years of effort in her terraced backyard. Despite rocky soil and areas of deep shade, her flowers blossomed, and the garden thrived. I do not know if her skills as a gardener were innate or learned through trials and failures, but I know my garden could certainly benefit from her guidance now.
In the medical field, there is a long-held misconception …
Rosalynn Carter’s impact on caregivers
I’m writing this in November, which is National Caregiver Month. It’s also Alzheimer’s Awareness Month. But regardless of when you’re reading this, if you’re a caregiver, every month is “caregiver month.”
Ironically, it’s also just a few days after the former first lady, Rosalynn Carter, passed away. She was acutely and astutely aware of the role of the caregiver and the toll that it can take on you. She so insightfully …
Uncovering the truth behind my father’s tragic end
I was the “stranger” at my father’s bedside. Shortly after his 84th birthday, my father fell and landed in the hospital with a split scalp. His metastatic prostate cancer was an incidental finding, and superimposing this wildly invasive tumor on his Parkinson’s-compromised body marked his first steps onto his death path.
I came to my father’s final illness as his daughter, a doctor, and a clinical bioethicist. While I was unable …
Embracing life’s purpose in the face of inevitable death
“I cannot escape death, but at least I can escape the fear of it.”
– Epictetus
I wish more people knew that quote during the pandemic. I write this on November 1st, celebrated as Dia de Muertos or “Day of the Dead.” Epictetus and the other Stoics knew that death is inevitable, that life can change in an instant, and viewed it as a reminder to live each day purposefully and virtuously. …
Intensive caring: Reminding patients they matter
Dame Cicely Saunders, the founder of the modern hospice movement and palliative care, famously said, “You matter because you are you, and you matter to the last moment of your life.” This quote has become the central philosophical tenet of palliative care. It implores us to remind patients, who may be feeling helpless, hopeless, or worthless, that they matter. There is abundant evidence that patients approaching death are susceptible to …
Exploring psychedelic therapies [PODCAST]
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Join Thaís Salles Araujo, an internal medicine resident. Discover the potential benefits, challenges, and the need for greater awareness and education in integrating these therapies into modern medicine. Gain insights into the evolving landscape of patient care, with a …
The power of listening in palliative care consultations
Finishing up a consultation in the ICU, the nurses approached me to see how it went. “Did you get the DNR?” I explained that I enter these conversations without an agenda. My first goal is to develop rapport, reading the room to gauge how far I can take this conversation. What are they ready to hear? This phase of the consult is akin to preparing the soil for planting. The …
Open conversations about end-of-life care
An excerpt from The Adventures of Dr. Anonymous.
During the COVID pandemic, I wished I could put out a public service announcement for physicians, patients, and families about end-of-life care. Palliative care is critical to hospitalist practice and one of the least discussed fields of medicine. It also is a major …
End-of-life ethics and antibiotic use [PODCAST]
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Join Althea Halchuck, a patient advocate. We explore critical insights into end-of-life care, the ethical considerations around antibiotic use, and the quest for a peaceful, dignified death. Delve into the complex world of health care decision-making in …
Empathy and compassion in palliative care [PODCAST]
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Join Vickie Leff and Terry Altilio, both palliative care social workers, as we delve into their book, Mirrors and Windows: Reflections on the Journey in Serious Illness Practice, which offers a profound exploration of the experiences of health care professionals, including palliative social workers, in the world …
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Dying is a selfish business
An excerpt from A Caregiver’s Love Story.
Whether you are the dying or the caregiver, living life to the fullest remains your goal, but somedays it’s just too darn hard. When you are so busy that it doesn’t seem you have time to take a breath, where does living …
Don’t disrupt success in Medicare
Each year, Congress goes through its annual budget process to determine how to spend more than $6 trillion on America’s priorities. This year, as part of the discussions on how to spend Medicare’s $900 billion budget, we are being told the Medicare Trust Fund, which is projected to spend $415 billion in 2023 for Part A expenditures, which cover inpatient hospital, skilled nursing facility, nursing home, home health, and hospice care, …
Terminal illness: Navigating the struggles of acceptance
Reality knocked me for a loop one evening when my father-in-law called from his home in another state and asked for help. This kind of request was very uncharacteristic for him. We responded immediately and drove to his home. After much conversation and many questions from both sides, we eventually came to the hard truth. His cancer had progressed and, to my mind, was most likely terminal. I dug in …
The old man’s friend: Refuse antibiotics to achieve a peaceful death
“If you don’t know how to die, don’t worry; Nature will tell you what to do on the spot, fully and adequately. She will do this job perfectly for you.”
– M. Montaigne (1533-1592)
In 2021, former U.S. President Bill Clinton was rushed to a California hospital suffering from a urinary tract infection that had developed into sepsis, a life-threatening blood infection. According to the National Institute of Health and Care Excellence, …
A space to pause, reflect, and be in community
An excerpt from Mirrors and Windows: Reflections on the Journey in Serious Illness Practice. This reflection was written by Chris Onderdonk, one of over 50 contributors.
I’m sitting next to Tony in the surgical intensive care unit doing my best to make out what he’s writing. He’s intubated and I’ve just …
Providing care to conflicting beliefs [PODCAST]
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Join Tyler Jorgensen, an emergency medicine and palliative care physician, and discover the profound insights he shares on the value of home visits in patient care. Explore the complexities of handling challenging situations, such as encountering conflicting …
Grief and healing: Navigating loss and meaningful connections
My wife, Ruth, passed away in April, and I am currently struggling with the immense loss. I deeply miss her, and for the most part, I feel terrible. I haven’t reached a point of “getting over it.”
Since her death, numerous people, including relatives, friends, acquaintances, and caring individuals throughout my day, have approached me with the same question: How am I doing? Despite multiple attempts to respond, I still haven’t …
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Past Week
-
Why are medical students turning away from primary care? [PODCAST]
-
Here’s what providers really need in a modern EHR
-
Why “do no harm” might be harming modern medicine
-
Why doctors are reclaiming control from burnout culture
-
How community paramedicine impacts Indigenous elders
-
A physician’s reflection on love, loss, and finding meaning in grief [PODCAST]
-
Past 6 Months
-
Why are medical students turning away from primary care? [PODCAST]
-
Why tracking cognitive load could save doctors and patients
-
Why “do no harm” might be harming modern medicine
-
Here’s what providers really need in a modern EHR
-
What the world must learn from the life and death of Hind Rajab
-
How medical culture hides burnout in plain sight
-
Recent Posts
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A physician’s reflection on love, loss, and finding meaning in grief [PODCAST]
-
How fragmented records and poor tracking degrade patient outcomes
-
How New Mexico became a malpractice lawsuit hotspot
-
How I learned to stop worrying and love AI
-
Understanding depression beyond biology: the power of therapy and meaning
-
Why compassion—not credentials—defines great doctors
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