I write a lot about end of life conversations that go well or have unexpectedly positive outcomes. But to be fair and balanced, you should also hear about the ones that don't go so well, lest you be led to believe that I have magical powers over my patients and their families.
Here are two of my attempted end of life map conversations that did not go over so well. In fact, ...
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Throughout the course of my career I have probably been with hundreds of people as they transitioned into and out of death. Although I am familiar with what this journey looks like, I have not yet been privy to the journey myself. Rarely though, I have had the pleasure of listening to someone who has journeyed back from death and arrived with a story to tell. Regardless of your position ...
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Please raise your hand if you are not going to die.
If you haven’t found the fountain of youth and we haven’t perfected anti-aging technology, then you my friend are going to die. But you are not alone, so am I, and so is your mother and your father and your brothers and sisters and even little Johnny down the street.
Now that I have reminded you of your own mortality. Does ...
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When you set out on an unfamiliar journey, you will need a map to get to your desired destination. You may pass landmarks, but not know exactly where you are unless you are able to identify these landmarks on your map. The same is true for the journey of life, and specifically, the path at the end of life.
You may know ...
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I pulled the stifling surgical mask off my face as I left my last patient’s room. I had just finished suturing a complicated facial laceration and was bone-tired from the evening. Glancing at the clock, I saw that mercifully, my shift was over.
Collapsing into my chair to finish up my charting, I was slightly annoyed when my nurse held a clip-board in front of my face, “Here is your next ...
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I just took care of a precious little lady, Ms. King (not her real name), who reminded me that, too often, we doctors are practicing irrational medicine at the end of life. We are like cows walking mindlessly in the same paths; only because we have always done things the same way, never questioning ourselves. What I mean is that we are often too focused on using our routine pills ...
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The baby boomers, the largest generation in American history, are now almost all in the last third of their lives (if average life expectancy is 78). They have spent the previous, early and middle thirds of their lives transforming cultural ideas, expectations and practices (e.g with the civil rights movement, environmental movement and women’s movement, etc).
The question now is, “Will the baby boomers also transform our cultural ideas, expectations, and ...
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The names of things often greatly affect our perception. In end of life lexicon, there is a movement underway to change the name of the medical order DNR (do not resuscitate) to AND (allow natural death). No change in the medical reality of what occurs, but a radical change in our emotional reaction to the each term.
DNR: "They withholding a medical intervention" (evoking negative feelings).
AND: "They are giving care that ...
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Mr. Omer had once held a position of social prominence, a moral influence on the lives of individuals and communities. Until one year ago. A construction accident changed everything. He suffered injuries that left him in control of only one side of his body and his mind functioning as a 5-year old child.
Most recently, he had resided in an extended rehabilitation nursing facility, until yesterday.
When the nurse tried to arouse ...
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I had just put him on a ventilator. Mr. Barnes (not his real name) had come in by ambulance sweating, barely responsive, gasping for air. The paramedics said he was from the local rehabilitation hospital and had just been sent there 2 weeks ago after a protracted hospitalization for a stroke which had left him partially paralyzed. Then they showed me medical orders indicating that he was “full code,” medical ...
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