Category: Palliative care

When the train comes for you

I found you standing on a platform. It was a foggy, damp morning, and your vision was obscured. People came and went, some with urgency, others not so much. Some people you knew, others were strangers. Your husband was usually nearby, often holding you…

The Talk Seniors Need To Have With Doctors Before Surgery

Surgeons are rethinking the old notions of “informed consent.” With older patients especially, a push is on to talk candidly about what a surgery will do, its risks and how it will affect their quality of life.

What is the best way to care for a dying patient?

Every morning, after rounding on Mr. Gregory, I felt like an imposter. As I reported on the worsening crackles in his lungs, his decreasing urine output, the mottling of his hands, we continued to simply give him Dilaudid for pain and continued to ensu…

Do substituted decisions break the Golden Rule?

The way I learned the Golden Rule was: “Do unto others as you would have them do unto you.” Basically, it’s from the New Testament, but the concept goes way back to pre-Christian ancient civilizations in Babylonia, Egypt, India, and C…

How to have an exciting death: 5 tips from a palliative care physician

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 fai…

How a patient saved this physician from losing her passion for medicine

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, an…

How a patient saved this physician from losing her passion for medicine

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, an…

A family meeting in Navajo Nation

“Let’s start the powwow,” a man with a brown jacket and braided ponytail said with a smile. Nineteen adults and one child filled the back conference room of the hospital. The hospital had made an industrial cylinder of coffee for the …

A family meeting in Navajo Nation

“Let’s start the powwow,” a man with a brown jacket and braided ponytail said with a smile. Nineteen adults and one child filled the back conference room of the hospital. The hospital had made an industrial cylinder of coffee for the …

Talk with family members about their wishes long before you think you’ll need to

I’ve been a doctor for a bit under a year now. I am a family medicine intern, working in blocks at a city hospital, wearing a lot of different hats. Sometimes I’m on the labor and delivery floor, helping new lives begin; sometimes I’m on the family med…