“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 ...

Read more...

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, ...

Read more...

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 ...

Read more...

By now you’ve surely heard that Medicare is going to pay doctors and other qualified health care providers for advance care planning with patients in 2016. Aren’t you excited? OK, so if you are not utterly thrilled or even if you are nonplussed about the whole issue, then let me give you a different perspective on why you should rush into your friendly local doctor’s office to make a living will and ...

Read more...

asco-logo She had been a patient for several years, and I still remember meeting her that first time: Her breast cancer was stage IV at diagnosis, already established in her bones; she was scared; she was in pain. Surgery was taken off the table, and she was referred for medical therapy. We had discussed prognosis, the incurableness of her cancer, ...

Read more...

This New Year is the appropriate time to make a resolution: the occasion to link advance care planning with a spiritual legacy.  People all have deep-seated values and determinations of what they are willing to pay for, live for and die for, but few actually document these for caregivers or posterity. Beginning in 2016, Medicare will begin to reimburse physicians for end-of-life counseling. However, throwing taxpayer dollars at no-win situations is ...

Read more...

I donated blood today. I'm one of those people who doesn't shudder at the thought of needles piercing my skin, or get queasy as I watch the blood drain from my vein into the collection bag. It's no big deal. I eat the cookies and drink the juice afterward, and I kind of enjoy talking with the elderly volunteers. I think I'm lucky. I know so many people who are sickened ...

Read more...

“It is far more important to know what person the disease has than what disease the person has.” - Hippocrates The Internet has the ability to connect us regardless of geographic location, socioeconomic status and age -- it really has no boundaries. I grew up in a time when today’s technology was not the norm and having a pen pal offered you a way to connect with someone you didn’t otherwise know. Nowadays, ...

Read more...

A presentation given to the bioethics committee, Sacred Heart Hospital, Pensacola, FL. My presentation today is about the challenge, professionally and emotionally created by certain external forces, which encompasses bioethical issues when one's roles merge. I am privileged and blessed to have many roles in my life: physician, wife, daughter, mother, now grandmother, sister, aunt, friend, and colleague.  At times, these roles blend, other times, they are murky and can cause intense ...

Read more...

"How much experience do you have with human suffering?" It was a question asked of me at my first medical school admission interview, and it took me by surprise. I was expecting to be asked about my volunteer experience, my research, or my desire to become a physician. The simple truth is that most of us really don't have that much experience with human suffering when we're in our 20s. The ...

Read more...

Most Popular