My first week on call, I got called in for a code blue. This patient happened to be the sickest patient on our unit. He had a tumor on his brain stem that was affecting his vision, hearing, swallowing, and breathing, so he had received a tracheostomy and gastrostomy tube as most palliative patients in his situation do. After a series of neurosurgeries, he was undergoing chemotherapy and radiation treatments. ...

Read more...

Dear Mrs. J, I would like to express my deepest condolences on the passing of your mother. She was a magnificent woman, and I had the pleasure of being her doctor for almost a decade. It was a pleasure. During our short visits, she regaled me with stories of childhood and often gently sprinkled in advice gleaned from years of experience. Even as she began to decline, we would sit together ...

Read more...

He was the last. Old and wizened, he counted down his final days, his final hours on earth. He lay in his bed, the rain drumming monotonously on the window. Night came. He pressed the button to call the aide. The aide appeared at his bedside. Every night, the old man had the same request. The aide went to the window and briefly pulled aside the curtains. He peered outside. ...

Read more...

asco-logo As an oncologist, I have witnessed patients go home and heard later how they died there, surrounded by family and friends. I have seen others die in a hospital room, comforted by the care of the inpatient team even as they depart this earth. These are the ones that stick with me and what I think about when ...

Read more...

As an internist and geriatrician, I deal with elderly patients all the time. We always end up talking about end-of-life issues: “Should I be resuscitated if my heart stops and I stop breathing?" “Do I want a feeding tube or gastrostomy tube if I stop eating and require nutrition?” “Should I be kept alive on machines and for how long if there is no reasonable hope of recovery?” “When should we refuse tests for ...

Read more...

When patients and their families seek hospice care, they are thinking about how they will die. They want to be without pain, shortness of breath, loneliness and, above all, fear. They want to end their lives with those they love, in a place they know, with respect and support. They want control. They want dignity. We all know this, and try to provide it as friends, family and caregivers. Nonetheless, ...

Read more...

Today I saw a news story about Walnut, an 18-year-old whippet in the UK, who had his last "walk" on the beach with his owner who had asked social media followers to join them. Shortly after that walk, surrounded by hundreds of family, friends, and supporters (human and canine alike), Walnut was put down. His last moments were spent as near to Heaven on earth as his owner could create ...

Read more...

I dreaded Mr. L’s office visits. His mouth half vacant of teeth and his clothes reeking of hand-rolled cigarettes, he regularly demanded medicines he didn’t need. He was pushy and thankless. I frequently declined his requests. He stuck with me anyway. Over the years he grew in orneriness. Divorced, childless, and unemployed, he declared one day that he was tired of living. He was reasonably healthy. He disavowed depression. Would I ...

Read more...

Otis was our first baby. He was covered in a caramel-colored fur, weighed 150 pounds and was the best bullmastiff dog anyone could ask for. He protected me from my husband’s incessant tickle attacks and thought that my lap was the best place for him to try and sit. Two years ago, I was walking Otis and he suddenly collapsed. After an extensive workup, including an EKG, blood work and an ...

Read more...

Man has been dying on a regular basis for millions of years — should we not be end-of-life experts by now? Why do I feel the need to devote pages and hours to this depressing topic? Is there a goal to my project, beyond venting the shared suffering which soaks my soul? What is my purpose? For humans, denial of death and marginalizing its effect on our lives is a major ...

Read more...

31 Pages

Most Popular