Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

When it comes to end-of-life care, perhaps we do need a bigger hammer

Richard D. Sontheimer, MD
Physician
September 25, 2015
410 Shares
Share
Tweet
Share

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 my mom that we lived in one of the 48 states in the USA that does not have a death-with-dignity euthanasia law.  Her response was, “Then can you move me to Oregon or Washington?”

While suffering several progressively debilitating physical ailments over the past two decades, my mother’s mind had remained razor-sharp.  As an example, during one of her more recent calmer moments when her hospice nurse was present my mom stated, “Even trying to pronounce the name ‘lorazepam’ could kill a person.”

When your body is failing you more every day, every hour, every minute, retaining one’s mind is not necessarily a good thing near the end of life.  And then the final insult.  It is called “terminal agitation.”

The biochemistry of imminent death makes it impossible to find a comfortable position.  You hurt all over.  You insist on getting up out of bed, but that does not bring you comfort.  You then quickly lay back down in bed, but that too brings no comfort. You become increasingly agitated and confused.  Your family members may not understand what is happening and may implore you to stay in bed and rest.  You may no longer recognize your family members.  You may even come to curse them.  Your family becomes fearful because it is becoming difficult for them to recognize you as they had known you to be before.

A recent diagnosis of inoperable stomach cancer had brought my mom and me together for such unpleasant nightly discussions.  The modern health care system had failed my mother. Two extensive, invasive, uncomfortable and costly hospitalizations over the past year had failed to find the source of repeated episodes of bleeding from her gastrointestinal tract. Finally, after she began to have trouble swallowing food, a last such examination revealed a large bleeding tumor in the upper part of her stomach.  By that time, only palliative treatment remained.

About a year ago I was struggling to help my mom with a household chore in her condo when she said to me, “Son you might need a bigger hammer for that.”

My mother was a member of the “Bigger Hammer” generation, alternatively known as the Ladies Auxiliary of the Greatest Generation.  Through hard work, native intelligence and sheer will she moved on from high school graduation to becoming a single, working mother at 18 years of age.  She went on to become a successful, independent small business person.  Hard work became her friend, her mantra and ultimately her closest companion.  Other men came and went in her life. But I was the only man there as she neared death.

And along the way she had generously supported her only child all the way to medical school.  A mother never was nor ever will be born who could have loved and supported a child more than mine did.  Thus, as a physician and grateful son, being unable to help her more at this most difficult time of her life was even more frustrating and saddening for me.

And when it comes to end-of-life care, perhaps we do need a bigger hammer.  But that hammer needs to be wrapped in the softest and loveliest of velvets.  And that gentle hammer needs to be made readily available to anyone whose mind remains sharp as they near the end of their final journey.

Several days following our last conscious interaction my mother passed away quietly wrapped in the comforting arms of Morpheus.  The angels of Hospice were finally able to help my mother in her time of need when neither she herself nor I could.

They do shoot horses don’t they?

Rick Sontheimer is a dermatologist.

Image credit: Shutterstock.com

Prev

Doctors: All of you have a superpower

September 25, 2015 Kevin 23
…
Next

Osteoporosis: A silent assailant turned me from physician to patient

September 25, 2015 Kevin 1
…

Tagged as: Palliative Care

Post navigation

< Previous Post
Doctors: All of you have a superpower
Next Post >
Osteoporosis: A silent assailant turned me from physician to patient

More by Richard D. Sontheimer, MD

  • A Father’s Day golf game to remember

    Richard D. Sontheimer, MD
  • Hope, with a ribbon of uncertainty curling gently around it

    Richard D. Sontheimer, MD
  • Should your child try for medical school?

    Richard D. Sontheimer, MD

Related Posts

  • Why health care replaced physician care

    Michael Weiss, MD
  • A real-life example of irrational health care spending

    Taylor J. Christensen, MD
  • How social media can help or hurt your health care career

    Health eCareers
  • End-of-life care talks begin at home: even for doctors

    Abdel Albakri
  • Can the dwindling numbers of primary care physicians explain decreased life expectancy?

    Niran S. Al-Agba, MD
  • Health care in American is on life support, and the future is uncharted

    Manoj Jain, MD, MPH

More in Physician

  • Reigniting after burnout: 3 physician stories

    Kim Downey, PT
  • Inside the grueling life of a surgery intern

    Randall S. Fong, MD
  • The shifting landscape of gastroenterology manpower and compensation

    Brian Hudes, MD
  • Surgical procedures for inpatients: Addressing socioeconomic urgencies

    Deepak Gupta, MD
  • I’m a doctor, and I almost died during childbirth

    Bayo Curry-Winchell, MD
  • A message of hope for physicians

    Kim Downey, PT
  • Most Popular

  • Past Week

    • I’m a doctor, and I almost died during childbirth

      Bayo Curry-Winchell, MD | Physician
    • Reigniting after burnout: 3 physician stories

      Kim Downey, PT | Physician
    • Motorcycle helmet laws: Balancing freedom and financial impact

      Stephen Cohn, MD | Conditions
    • Balancing efficiency and compassion [PODCAST]

      The Podcast by KevinMD | Podcast
    • The link between orofacial myofunctional disorders and dental health

      Stephanie Jeret | Conditions
    • How compassionate leadership saved this physician [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Medical gaslighting: a growing challenge in today’s medical landscape

      Tami Burdick | Conditions
    • Balancing opioid medication in chronic pain

      L. Joseph Parker, MD | Conditions
    • I want to be a doctor who can provide care for women: What states must I rule out for my medical education?

      Nandini Erodula | Education
    • Navigating the broken medical system: challenges faced by foreign medical graduates

      Anonymous | Physician
    • Mourning the silent epidemic: the physician suicide crisis and suggestions for change

      Amna Shabbir, MD | Physician
    • The essence of medicine: genuine connections in practice

      Jennifer Tillman, MD | Physician
  • Recent Posts

    • Balancing efficiency and compassion [PODCAST]

      The Podcast by KevinMD | Podcast
    • Reigniting after burnout: 3 physician stories

      Kim Downey, PT | Physician
    • Why patients write: stress relief, self-care, and sharing experiences

      R. Lynn Barnett | Conditions
    • Inside the grueling life of a surgery intern

      Randall S. Fong, MD | Physician
    • Misinformed claims and the offensiveness of discrediting COVID-19 vaccine development

      Angel Garcia Otano, MD | Conditions
    • Bitcoin’s role in diversified portfolios [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 5 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • Did Gabapentin Improve Post-COVID Olfaction?
  • Fentanyl Death Trends; Food Additives and Heart Disease
  • What If the Doctor Is Out?
  • Reduced Mortality Seen in Cancer Survivors Who Meet Exercise Guidelines
  • CDC Advisors Endorse Maternal RSV Vax to Protect Newborns

Meeting Coverage

  • Loneliness Needs to Be Treated Like Any Other Health Condition, Researcher Suggests
  • Stopping Medical Misinformation Requires Early Detection
  • AI Has an Image Problem in Healthcare, Expert Says
  • Want Better Health Outcomes? Check Out What Other Countries Do
  • ERS Roundup: Cell Transplant Boosts Lung Function in COPD Patients
  • Most Popular

  • Past Week

    • I’m a doctor, and I almost died during childbirth

      Bayo Curry-Winchell, MD | Physician
    • Reigniting after burnout: 3 physician stories

      Kim Downey, PT | Physician
    • Motorcycle helmet laws: Balancing freedom and financial impact

      Stephen Cohn, MD | Conditions
    • Balancing efficiency and compassion [PODCAST]

      The Podcast by KevinMD | Podcast
    • The link between orofacial myofunctional disorders and dental health

      Stephanie Jeret | Conditions
    • How compassionate leadership saved this physician [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Medical gaslighting: a growing challenge in today’s medical landscape

      Tami Burdick | Conditions
    • Balancing opioid medication in chronic pain

      L. Joseph Parker, MD | Conditions
    • I want to be a doctor who can provide care for women: What states must I rule out for my medical education?

      Nandini Erodula | Education
    • Navigating the broken medical system: challenges faced by foreign medical graduates

      Anonymous | Physician
    • Mourning the silent epidemic: the physician suicide crisis and suggestions for change

      Amna Shabbir, MD | Physician
    • The essence of medicine: genuine connections in practice

      Jennifer Tillman, MD | Physician
  • Recent Posts

    • Balancing efficiency and compassion [PODCAST]

      The Podcast by KevinMD | Podcast
    • Reigniting after burnout: 3 physician stories

      Kim Downey, PT | Physician
    • Why patients write: stress relief, self-care, and sharing experiences

      R. Lynn Barnett | Conditions
    • Inside the grueling life of a surgery intern

      Randall S. Fong, MD | Physician
    • Misinformed claims and the offensiveness of discrediting COVID-19 vaccine development

      Angel Garcia Otano, MD | Conditions
    • Bitcoin’s role in diversified portfolios [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

When it comes to end-of-life care, perhaps we do need a bigger hammer
5 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...