“Son, just let me die.” Those were the first words Mr. O. told me as I introduced myself. As a 75-year-old stage IV lung cancer patient with brain metastasis, Mr. O knew his time on this planet was limited -- the last place he wanted to be was in a hospital with a newly minted clinical student. Mr. O’s neighbor had found him unconscious on his porch earlier this morning, and ...

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Even as a child, I noticed that many people, especially my Depression-era grandmother, feared aging and the imminence of death. Death was no stranger to me growing up; I lost my then best friend, my Nano, and my uncle as a child, both traumatically. Yet, death was sad, but natural. Because of this, I never understood our society’s stigma against dying, something that I've struggled with even in medical school. In ...

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An excerpt from Wishes To Die For: A Caregiver's Guide to Advance Care Directives. The great poet Rumi ascribes, “I should be suspicious of what I want.” Like many others, as I become older I look forward to Medicare paying for health care expenses. Being enrolled in Medicare makes health care available, ...

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Sedated by Oxycodone, Ted slept despite the rhythmic ruckus of his breathing machine. He never felt quite rested in the hospital. While awake, his gaze often lingered on a snapshot that captured him in the past: full of laughter and radiant joy with his little granddaughter, Tara. The grandfather in the photo -- muscular, mischievous -- barely resembled the emaciated elder in the bed who silently mouthed short answers to ...

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What if you woke up tomorrow and learned that your grandmother had been kidnapped overnight by a couple of strangers, thrown in a white van, and taken to a distant warehouse where she spent the subsequent forty-five minutes being tortured before finally succumbing to her death? Where she was repeatedly beaten in the chest, where a tube was shoved down her throat, where she was tasered with high voltage, where a ...

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The affection families express for their dying loved ones can take many forms.  Recently, I saw a spry 91-year-old Spanish-speaking gentleman with lung cancer which had consumed the better part of his right lung.  He had a large family with many doting daughters.  In his neighborhood, he was popular and well respected.   He, according his family, had "many girlfriends."  His lung cancer was no doubt a result of a ...

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"It's those pain medicines you are giving her.  She’s very sensitive to them.  I think that’s why she’s confused -- she is doped up." Two months after receiving her diagnosis Mrs. M signed up for hospice.  At our first visit, she was suffering and visibly uncomfortable.  Her skin appeared excoriated from weeks of scratching.  She was confused, restless, and racked by pain. Mrs. M had metastatic liver cancer resulting from underlying cirrhosis.  ...

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“Oh God!” she groaned, looking upward with tears flooding her cheeks, which were stretched into the shape of agony. Her chest heaved uncontrollably with grief. “I am so very sorry,” I whispered again while leaning in and stroking her hand. This is what death notification often looks like and feels like. We doctors should be masters of delivering some of the worst news that could ever be uttered; the worst news that ...

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As I sat in my hospice interdisciplinary group meeting, reviewing the many patients who have died in the past two weeks as well as our new patients, there was a slight break in the discussion. Being ever the multitasker, I clicked on a New York Times article I had been meaning to read and scanned the first two sentences:  “When my husband died from cancer last March at age 37, ...

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Thomas Hobbes described life as pitifully “nasty, brutish, and short.” Thanks to the free market and the state, life is no longer a Hobbesian nightmare. But death has become nasty, brutish, and long. Surgeon and writer, Atul Gawande, explores the medicalization of ageing and death in Being Mortal. Gawande points to a glaring deficiency in medical education. Taught to save lives and fight death, doctors don’t bow out gracefully and ...

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