I know you want to. I know you would rather have anything other than dementia—even cancer. I know you are happy with your life and want it to continue as it is. If it has to change, I bet you’d like to slowly become more frail until one night you just die in your sleep. You do not want to slowly become more confused. You don’t want to live ...

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The chances that you or someone you love will be diagnosed with dementia are shockingly high. By age 65, your chances are already at 9 percent. Make it to age 85, and the chances go up to 33 percent. Of course, if you’re diagnosed with dementia, it will be a struggle for you to think clearly about your diagnosis. So, today, while all of your faculties are still intact, I’d ...

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First, you have to call up your daughter to pick you up and take you to the lab. It’s hard for the nurse to find your vein. The pain from his fishing around in your arm is not nearly as bad as the pain you always have in your hip, and back, and shoulders, but it’s the straw that breaks the camel’s back, and you cry a little bit. The ...

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Because everything around us usually works, it can be easy to forget how fragile some of the workings are. My patients see this with their bodies, as they fail, but not so apparent to them are the fragilities of the health care system that we doctors get to see. Despite what the if-it-bleeds-it-leads press might have you thinking, our health care system is pretty good. Good, however, is never good enough, ...

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When I graduated from residency, I was too worried about killing my first few patients to examine the meaning of being an attending physician. An early patient, a 97-year-old retired doc, brought it to my attention. “Being an attending physician means you attend. When you attend me, all I want you to do is show up. You do not have to do anything. Keep the people with needles, knives, and nonsense away from ...

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Dr. Ryme had been retired at least thirty years from medicine when he met me, his last pupil. I was a freshly minted doctor, and he became the first teacher of a new course at my new school called “Life as an Independent Doctor.” At our first office visit, after telling me his life story, he quizzed me, “And furthermore, Dr. Braun, you’re an attending physician now. You are no longer ...

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I saw Kaitlin (identifying information changed) and her husband Brandon seven days before she died. Kaitlin's cancer had been in remission at our last visit, but this day she looked awful. I estimated she had less than three months to live. As I think being surprised by death is unhelpful, I decided to test whether they were prepared to take on bad news by mentioning that she didn't look like ...

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I made my 10:20 a.m. patient wait while I told my support staff about my day off. "I was getting an ice cream when I saw a car accident. By the time I got there, it was clear that there were no serious injuries and all I did was to distract the passenger so she wouldn't panic while we waited for EMS. Her husband hit a tree with their van, and ...

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