Dr. Leon Pedell discusses a topic that physicians of all ages often find difficult: dealing with hopelessness, end of life care, and the actual death of a patient. Courtesy of Before the Floors.

Whether you believe in science, God, neither or some combination of the two -- we can all agree that death is inevitable. Due to the finality of our lives, each of us should understand and prepare for that moment not only for ourselves but also for our loved ones. As medicine continues to advance and people live longer, we have a generation of baby boomers who are now entering their ...

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My friend and neighbor died last week.  In his early eighties, wiry, opinionated, well-read, he never tolerated schooling. He built an excavating business with a perfected aesthetic for contouring soil and also built a few homes in town including mine.  When he saw the architect’s lower pitched roof framed on the garage, he had it torn off because: “It just wasn’t right. It looks like a tiny bowler hat on ...

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I was covering for my partner over the weekend and saw his patient with end-stage liver disease, a consequence of decades of alcohol abuse.| He was one of the most deeply jaundiced individuals I have ever seen. His mental status was still preserved. He could converse and responded appropriately to my routine inquiries, although he was somewhat sluggish in his thinking. It’s amazing that even after the majority of a liver ...

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"Why don't you talk loud enough for the whole damn hospital to hear you?" I've just greeted my eighty-four-year-old grandmother, and now this irascible voice has erupted from behind the curtain that separates us from whoever is sharing Grandma's room. The nursing assistant whfo showed me in glares across the curtain at the other inhabitant. "You shut up," she tells the person firmly, "or I'll smack you with a bedpan." Then, she leaves us ...

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At first, you'll question reality. You will hear your own words, but they'll sound foreign — apart from you. The ground will still reassuringly push back against your toes when you walk out of the room, but you will wonder if they are your feet. Like in a movie, you will negotiate the world convincingly. Yet, you are an actor playing a part. It is not the real you. Be assured ...

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An excerpt from Life after the Diagnosis: Expert Advice on Living Well with Serious Illness for Patients and Caregivers. Serious illness doesn’t discriminate; it strikes patients of all ethnic and cultural ...

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I am working hospitalist right now. On Friday, a man in his 80s was admitted with difficulty breathing. He had a complicated history, including a heart attack at age 35 with all the subsequent sequela of heart disease. He had an abnormal heart rhythm and was taking a blood thinner for stroke prevention. In addition, he had scarring of his lungs (cause unknown). He was transferred to us from another hospital. ...

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When I was a practicing attorney, my colleagues and I would sit around at lunch, arguing about whose sandwich was better. Alone in our world of books and “right and wrong,” (as in “I’m right, and you’re wrong”), we spent hours creating problems to solve so we could make money. Lawyers -- like many professionals -- form their own little bubble, but unlike say, IT guys or architects, our bubble ...

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There was a lot about that place I didn't want to see or hear. The buzzing and whirring of ventilators; the loud call bells; near-dead patients; nurses running around with IV pumps and tubes dangling along behind them; the heart-stopping "Code Blue" warning; or the electrical sizzle of a patient getting shocked as someone screams, "All clear!" I didn't want to do it. Just a few days before, I had buried my mom. First ...

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