“So, I told the doctor at the nursing home that I loved my father more than anything. Dad was my friend and the most wonderful man I had ever known. I wanted everything for him. But, I said, Dad was sick, weak, confused, and he never wanted to live like that. The next morning he was dead. That was OK by me.”
I once participated in a panel discussion about hospice, …
Some people who know what I do don’t really know what I do.
They picture me floating through the hospital extinguishing lives, blowing them out one by one like candles down an endless corridor. They think I practice euthanasia, that my presence alone hastens death — that I consume hope and happiness like a black hole, compressing it all into nothingness. Some call me the Grim Reaper, others the Death Doctor. …
Mr. Dwyer isn’t my patient, but today I’m covering for my partner in our family practice office, so he’s been slipped into my schedule.
Reading his chart, I have an ominous feeling that this visit won’t be simple.
A tall, lanky man with an air of quiet dignity, Mr. Dwyer is eighty-eight. His legs are swollen, and merely talking makes him short of breath.
He suffers from both congestive heart failure and renal …
ESPN sportscaster Stuart Scott’s recent death has given the American public a chance to reflect on what it means to live with a cancer diagnosis. His speech at the ESPY awards in the summer of 2014 was widely hailed as an inspiration to people with cancer. Obviously, the Jimmy Valvano Award for Perseverance with the ties to cancer research (Jimmy V Foundation) and Scott’s public image as someone being …
Did I tell you that I was a big fan of palliative care? Palliative care started around 15 years ago at the VA where I worked. We saw the service evolve. We saw how the palliative care approach improved the quality of both life and death.
Many physicians have not yet accepted or at least understood palliative care. Many physicians use some palliative care principles and believe palliative care is superfluous. …
When teaching about life near dying, it is hard to achieve open conversation. No matter what one says in a lecture hall or what brilliant writers publish on the terrible state of end-of-life care, change is painfully slow. While we blame evasion by doctors of challenging conversations, failure by patients to plan or denial by families which blocks open communication, the …
“All your patients will die. Maybe not today, but someday. The defining fact of life is that it ends. Only a fool would dedicate their career to fighting something that can never be beaten. Therefore, a doctor’s task cannot be to fight death. A doctor’s task is to heal when possible and prevent suffering always. Our calling is to support life. Fighting death may deprive patients of the opportunity to …
“He’d feel okay about not replacing the pacemaker’s battery when it ran down, he said. But turning it off, he said, would be ‘too active.’ Later he would tell me that it would have been “like putting a pillow over your father’s head.”
These are the words of Katy Butler in her book Knocking on Heaven’s Door – The Path to a Better Way of Death in which she writes about her …
Ever wonder what a “gomer” is? While certainly passé and unprofessional, does it shed light into the frustrations both doctors and patients have with end-of-life care? Emergency physician and author Brian Goldman explains the origins and use of such medical slang in his book, The Secret Language of Doctors.
One of my most treasured stories as an ED physician belongs to a lovely couple who valued quality of life. It was a routine day in the ED when an elderly woman rolled through the ambulance doors on a cold, narrow stretcher, unaccompanied by family. She was placed in bed 5, which is where we met. She was frail and her memory was poor. The EMS run sheet reported “change …
Case 1: You have a 94-year-old woman with multiple medical problems in hospice who develops a fever (subjectively hot to the touch), shortness of breath, and a cough producing yellow sputum. Her daughter asks if she can be treated with antibiotics “to make her feel better.” The patient is not well enough to make decisions, but in earlier conversations had stated a goal of remaining comfortable at home, while also …
It is in our nature to lie. Falsehood is one of the most creative things we do and the most remarkable of the human arts. We construct castles from ether and support their ephemeral walls on a foundation of accepted truths, which themselves are wisps of previous lies. The more we live within lies, the greater the challenge and more the harm. We pay a heavy price for fabrication. What happens …
New Jersey is considering following four other states in legalizing physician-assisted suicide. The Death with Dignity Act would allow people with less than six months to live to receive a prescription for a fatal cocktail and then to commit suicide at the time of their choosing in the privacy of home. Recently, I had the opportunity to participate in a debate on the merits of the proposed law. While I oppose this …
ADVERTISEMENT
Many years ago when I was a “young” doctor, moonlighting in the ER of a tiny country town, I had an experience that challenged my training. You see, most young, new doctors often think their training and knowledge is superior to that of “old” doctors, which is often malarkey. A wise and sage old doctor in this tiny country town taught me an important lesson on where and how one …
After finishing medical school and my residency in internal medicine, I undertook an additional year of training in a field called palliative care. Patients who notice my background sometimes ask me what exactly palliative care means. It’s really a simple concept. Palliative care is helping people with a serious illness have the best possible quality of life. It’s enabling sick patients to make the most of the time they have left …
In 2008, the state legislature of Washington passed what was called the Death with Dignity Act, a law that legalized physician assisted suicide. Under the law, terminally ill patients (predicted to have less than six months to live) can request prescriptions for lethal medications from their physicians, under a series of safeguards: multiple requests for example, determination of competency, and the like. Then, if the patients so choose, they can ingest …
As part of the first-year curriculum, medical students at the David Geffen School of Medicine at UCLA are required to attend chaplain rounds at local hospitals during which they accompany chaplains to offer spiritual care to patients. This is designed to encourage students to empathize with patients who are enduring difficult end-of-life issues and is part of a ubiquitous and important theme that inundates almost every medical student across the …
An 85-year-old woman with moderate Alzheimer’s disease who enjoys walking in her nursing home’s garden with her walker has fallen and broken her hip. An advance directive signed by the patient states a preference for “comfort measures only,” and specifically states that she does not want to be transferred to the hospital. The physician believes that surgery would provide long-term pain relief and the chance to maintain some mobility.
What do …
To resuscitate or not to resuscitate, that is the question. Whether ’tis nobler to beat the heck out of a person on his or her way out in the hope of saving his or her one precious life, or to allow death to proceed at its own pace with expectation of a peaceful passing.
The United States has come a long way in the last 2 decades since 1991 when the …
Watching my grandfather pass away changed my life. It wasn’t sudden and it shouldn’t have been unexpected. Yet it seemed unnatural, mysterious, and incredibly uncomfortable. I can still remember receiving the phone call from the hospital, my mother letting out a distraught cry that my grandfather was no more. My initial reaction was shock and confusion: I just couldn’t understand what had happened. Looking back, he had been under intensive …
Get free updates delivered free to your inbox.
