Hospitals have always served as a lifeline to survival. Whether from pneumonia, heart attack, stroke, or trauma, they have been a community safeguard between life and death. Today, a cost of care has been added to the patient treatment discussion forcing medical decision-making to look closely at expense. Financial considerations have come to the forefront as preservation of resources will be important to national health care. This can be a threat ...

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Mom. She was a feisty 100 percent Italian, straight from New Jersey. Her dad, straight from Italy, was a tailor and made the finest suits for New York and New Jersey businessmen. Mom learned this trade well. She could sew some of the most beautiful tailored suits for herself. She loved to cook and every night was a banquet, a feast which required up to 2 hours of clean-up time ...

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The world can be a lonely place. Despite technology designed to bring us closer, it seems we've become more isolated. We view profiles rather than embrace complete individuals. We spend hours crafting a persona, a smooth and unblemished public face. Raw, unattractive emotions: grief, insecurity, jealousy. We mask those from others and even hide them from our deepest selves. Ultimately, rather than becoming more connected, I suspect we are cast ...

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I knew it was bad when she couldn’t tell me her name. I watched her face fill with frustration as a word she had uttered countless times over eight decades somehow got lost between her brain and her lips. It was 2 a.m. and I was on call as the surgical resident. I had been told that a patient with bladder cancer was being transferred from another hospital, and, as these ...

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During the first few days that my mother spent in hospice, I silently sat by her bed watching her chest rise and fall, listening to her moan, counting her doses of Ativan, Tylenol, and Morphine, and tallying the days she’d been without food and water. On day five of my vigil, I asked her nurse, “How long can Mom live like this? She hasn’t opened her eyes or eaten or had ...

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Ruth was a spry, but frail 98-year-old woman who was stiff and sore following the 6-hour drive from California to Arizona. She had suffered a recent wrist injury and was not recovering well after spending three weeks in a rehabilitation center. She was in the midst of upheaval and discontent -- in the throes of relocated to an assisted-living residence closer to her son. The facility’s coordinator had begun to ...

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The only thing I love more than complaining about being a doctor is actually being a doctor. Intern year sucks. There’s no way around it. I wake up at 5:15 a.m. to get to the floor at 6:00 a.m. and I rarely leave at 5:00 p.m. when my shift is scheduled to end assuming I’m not on call until 9:00 p.m. I often feel my stomach growl at 9:00 a.m. and ...

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They said, "Do everything." She knew something was wrong. And by the time she was 85 she had forgotten the names of her children, the town she raised them in, even the name of her deceased husband. In her 70s she was diagnosed with Alzheimer's. Still coherent, she talked to her physician about becoming a DNR: do not resuscitate. She did not want to live on a machine that would breathe ...

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I make my way down the aisle of the plane, squeezing past my fellow passengers and plop down in my assigned seat.  Sitting next to me is a middle-aged woman with a kind smile. As the plane takes off, she begins making small talk: ”What do you do?” I silently debate, do I adopt my travel persona or answer truthfully?  Answering honestly will result in one of two things; either we ...

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I slipped and fell. My hip fractured, surgery would make it better. But it didn't. My body was too weak to fight. I couldn't cough and deep breathe; I stayed in bed. I had nausea and vomiting. I couldn't breathe. I became weaker and weaker, until my family noticed. The medics rushed me into the ER. My blood pressure was 62/34. For how long? The ER nurses and doctors tried ...

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