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 ...

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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, ...

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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 ...

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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 ...

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“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, ...

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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 ...

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"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 ...

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Medical school and medical training attempt to teach subjective humans how to think and practice medicine objectively. This may be one of the unique fallacies of modern medicine, but that’s a subject for a different blog. Nevertheless, even in the highly emotional field of emergency medicine I’m usually pretty chill. That is, until someone’s dying, and then all of my equanimity can go flying out the window, for better or worse. Such ...

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As I entered the exam room to meet my new patient, I initially thought of the orange-haired heroine in the animated kid movie, Brave. Although the middle-aged woman's hair was not quite as orange as the heroine's, it was long, expansive in breadth and wavy in texture. Her hair seemed to engulf her petite frame. As I looked at her more closely, she appeared rather slim. Her layering of clothing ...

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My patient’s son stood vigil outside her hospital room day and night. His eyebrows were frozen at an anxious angle. Although his mom was healing well from her injury, I could see that he was worried about next steps. He asked staff repeatedly about his mom’s pain management, and reviewed every therapy session she attended. His mom, on the other hand, was deceptively charming. She was a thin, well-groomed elderly woman ...

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