It is a pattern oft repeated in a lifetime: You go to the doctor’s office, get a prescription, and go home. You go to the urgent clinic, get care, and go home. You go the hospital, get better, and go home. But some people are very surprised when they go to inpatient hospice, are stabilized and told to go home. Inpatient hospice could be within a hospital, nursing home, or a dedicated hospice facility. The ...

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“Doctor, I am ready to die.” I knew her from a few years back. This patient of mine. I am a hospitalist and the patients in my care come and go, making it difficult to really form relationships like the ones primary care physicians have with their panel of patients. But this patient was different.  I saw her once many years ago when she was gravely ill, and we managed to pull her ...

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The extraordinary pain of many people around you is unaddressed, and the scale of that unmet need would shock you if you saw it. Compartments of privacy separate you from the experience of your neighbors and even your own families. I understand that you have been unaware as well as hopeful that our medical system will either fix the problems or, at least, soothe the pain. It does neither consistently. ...

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On a September night not long after his 83rd birthday, my father suffered a massive stroke.  It left him conscious yet unable to talk and communicate, unable to swallow, and almost completely paralyzed. After numerous scans and other tests, his doctors determined that there was no chance for recovery.  My father would never walk, talk, or swallow food again.  With nothing more to do for him in the hospital, we -- ...

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Do you truly understand advance directives?  With the help of Green Day, emergency physician Michael Barton seeks to educate with this fantastic video.

While sitting one evening with my terminally ill elderly mother, she again asked me to help her end her suffering.  This time it was, “Could you just go get the hammer and hit me in the head?” Her previous requests had included "Son, you are a doctor, can’t you do something to help me with this?”  And then, “They treat animals better than this.” On previous occasions, I had to remind ...

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I walked silently into the pristinely decorated room of the hospice facility and was greeted by her family.  She lay there, not particularly responsive to her surroundings under the pressure and influences of metastatic stomach cancer.  The warmness and smiles on the faces of her family told me that at some point and somehow, in the midst of actively witnessing the transition of their mother, aunt, sister, and grandmother, they ...

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shutterstock_240724267 Like so many other medical professionals, I felt voiceless in the face of a gargantuan health care non-system built to do things to people, rather than for people. But after a decade of hospital practice, my “cry for help” looked slightly different than the typical midlife crisis: It involved the creation of a somewhat ridiculous blue-scrubbed rapping doctor alter ego. “ZDoggMD” could ...

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“What is the meaning of life?” A perfectly reasonable question, albeit a strange one considering that I was in the third grade, it was recess time, and I was having a philosophical conversation about death with a grasshopper I had just caught. Ever since I could remember, I was fascinated by death. But my life was characterized more by loss than by death. When I was three, there were no funeral processions ...

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shutterstock_287499203 “Either way, no matter what we do, you’ll live less than 12 months, probably less than nine. Even if we were in the United States, your disease is incurable.” He nodded slowly in understanding. Jean Dominique was only in his 40s and had teenagers at home. “We can treat your pain and other symptoms, but we can’t do anything to treat the ...

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