The affection families express for their dying loved ones can take many forms.  Recently, I saw a spry 91-year-old Spanish-speaking gentleman with lung cancer which had consumed the better part of his right lung.  He had a large family with many doting daughters.  In his neighborhood, he was popular and well respected.   He, according his family, had "many girlfriends."  His lung cancer was no doubt a result of a ...

Read more...

"It's those pain medicines you are giving her.  She’s very sensitive to them.  I think that’s why she’s confused -- she is doped up." Two months after receiving her diagnosis Mrs. M signed up for hospice.  At our first visit, she was suffering and visibly uncomfortable.  Her skin appeared excoriated from weeks of scratching.  She was confused, restless, and racked by pain. Mrs. M had metastatic liver cancer resulting from underlying cirrhosis.  ...

Read more...

“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...

Most Popular