My gut churned, a burning rose into my chest as I read the email. It’s happening again repeated on a reel in my mind, followed by I need to leave this job. But I wasn’t quitting. I was triggered. It was years after I’d had the rug pulled out from under me at an institution where I’d spent decades working, but sometimes my nervous system sent me right back there.
I was a palliative …
An excerpt from At Heaven’s Door: What Shared Journeys to the Afterlife Teach About Dying Well and Living Better.
What brings you here?
I ask this question of every person who steps through the door because they have come to talk about death—the most universal of all human experiences yet the most difficult to discuss.
In modern culture, we have an uneasy relationship …
I will tell you exactly
And only the facts.
You are trapped a little for a time
And unhappy
Then your face hollows and it has a death mask
As the soul withdraws from the body
And you look at me and tell me who you see
It is always someone,
Sitting there like me,
But on the other side of things
Waiting for you.
And suddenly you become a column of white light
And leave the body all at once
Going upward,
I …
For the last couple of decades, I was trained to save lives. I sat shoulder to shoulder with others who drilled this in me when I was green, sometimes even through humiliation. I learned to perceptively read patient cues, develop quick reflexes, and think on the spot in critical moments, wherever and whenever life was compromised. I always threw lifebuoys into the ocean when I was called into action. This …
It’s one of the last weeks in December. If it was any other year, I would have realized that Christmas is around the corner, the air would be filled with a different, radiant, joyful kind of energy, and most of us would be focused on all the lessons this year has taught us. Unfortunately, this year is not like any other year. The air feels dense and heavy. You can’t …
As rising fourth-year medical students, we talked about caring for dying patients with Dr. Angie Anderson (AA), a pediatric palliative care specialist. An abridged version of our conversation is transcribed below.
Lindsey Pileika (LP): Honored to speak with you, Dr. Anderson. I just wanted to preface our interview with experiences that I’m bringing to this conversation. During my third year, I was working on the pediatric hematology-oncology service, where we frequently …
Physicians have gone toe-to-toe with death since the earliest days of the profession, even knowing that our efforts would often be futile. Over the past century, dramatic technological advances have nearly doubled the average American lifespan, and modern practitioners have a level of control over mortality previous generations could scarcely have imagined. But medicine has by no means conquered death. This puts health care providers in …
If a family member or friend asked you to serve as his/her medical power of attorney, what would your answer be? Many people agree to assume this role without a second thought, but you should take some time to understand what your responsibilities as a medical power of attorney would be, why the person has chosen you to do this, and what potential complications and conflicts may arise. With that …
In the KevinMD article, “Assisted suicide: a change of heart,” the author contends that there is salvation in suffering, but not everyone believes that is true. While I support the author’s ability to decide how she wants to die, I do not believe that her personal beliefs should dictate how I die.
I retired as an internist a few years ago because of declining health. I …
In today’s increasingly technological, data-driven, depersonalized world of health care, I wonder if the concept of “a good death” is even possible. The COVID-19 pandemic, in particular, has caused me to reflect on this. What does it look like? How do you define it? As I did, a patient came to mind. He was a retired minister in his 80s. I had cared for his wife as well until she …
My medical school’s secondary application, like that of many other medical schools, asked me to describe a personal or professional challenge or conflict and to explain how I worked to resolve it. However, unlike other medical schools, my school specified that they did not want to hear about the MCAT or another academic challenge.
For this question, I wrote about a challenge that I have been facing for most of my …
The image of patients dying in the intensive care unit is changing. Over the phone, family members cry on the other end as I tell them that we are not allowing visitors due to “the coronavirus” at this time. They tell me, “but I help make his decisions for him.” These decisions now have to be made over the phone.
This is just what we have to do to keep society …
Being a medical student during your clinical years imparts a certain feeling of invincibility. For many of us, this is our first-time taking care of patients. Our history-taking and physical exam skills are being honed like superpowers. Our clinical knowledge is growing. We begin to take ownership of patients as our own.
With all but two clinical rotations left in my third year, and at the peak of my own feelings …
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Returning from my week of vacation, I was greeted by the usual stack of mail, faxes, forms to be signed, throwaway journals, and a fully loaded group of in-basket messages that had piled up in the electronic medical record that needed attending to.
One of the pieces of mail was an unsolicited package with a bright red label on it, along with …
On October 1, 2019, Nevada began allowing individuals to avoid living in late-stage dementia. The new statute recognizes the legitimacy of an advance directive that instructs health care providers to stop hand feeding food and fluid by mouth. Individuals have already been completing such directives in New York and Washington. The Nevada law is the first that explicitly authorizes such instructions.
Growing …
“Planned death.”
When you put it like that, this can only mean one of two things: suicide or murder. For most of us in medicine, the very idea of “planned death” seems safely outside our purview. After all, the bulk of medicine is concerned with staving off death. And the very nature of death’s uncertain timing enables practitioners of everyday medicine to take refuge in its mystery.
When necessary, we prognosticate. But …
I, like many physicians, am the only doctor in my extended family. To say that they are proud is probably an understatement. I’ve been a practicing physician for seven years now and yet my grandmother each time I see her greets me with, “There’s my doctor grandson.” I have worked quite hard to get to where I am, and I enjoy what I do. I, too, am proud to be the …
We’re all gonna die.
It’s a simple truth that an astounding number of people neglect to acknowledge or accept. Some people die sudden, unexpected deaths, but most eventually fall victim to chronic or terminal conditions like COPD, heart failure or cancer. As a palliative care physician, I often meet patients who have had conversations with their families about their end of life wishes and have completed supporting legal documents.
While I appreciate …
I left a full-time academic position five years ago because I was literally, “check-all-the-boxes,” burned out. In looking back during that time prior to my decision to leave, I recall months of feeling overwhelmed, emotionally exhausted, depressed, and in a sense grieved for the loss of what I envisioned my career path to be until retirement. It was not until one of my favorite patients, Mr. Young, who knew me …
My wife Uzma died peacefully at home. She didn’t take any painkillers for her last three days. Our kids, my parents, and I were next to her. In the weeks leading up to her death, many old friends visited her. Others sent her flowers, cards, and food. It was a good death. Yes, in the last five years cancer and its treatment took a physical and emotional toll. Yes, she left us a …
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