Recently, a neighbor and friend of mine died. After her cancer was diagnosed as incurable, she was referred to hospice care, and family members traveled long distances to spend quality time with her during her last month of life. Her neighbors in our condo building clamored for slots in her packed social calendar. Two days before her death, she held a socially distanced open house for people lined up six feet ...

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"As a runner, my pulse rests around fifty, but the ICU team had worried when it dipped to thirty-five, and my blood pressure hovered around ninety over fifty. Understandably, bags of saline were hung, and steroids were added. My headache improved, but my ankles disappeared, and I was often short of breath. Upon discharge, I went into full diuresis mode and ...

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I am no stranger to death. I have gently closed the eyelids of a woman dying from liver disease, blasted Led Zeppelin by request during a man's last breath, and exchanged dog photos with an elderly gentleman on his final day. Although I cared for these patients deeply, our relationships were defined by illness. Ms. B was different. Healthy and curious, she had sat in my clinic countless times with ...

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Every time I visit my great grandmother, Tata, Atul Gawande’s Being Mortal floods my thoughts. Tata is 101 and developed severe dementia within the past two years. In 2019, she fell and fractured her hip. In the hospital, she recovered poorly. The physicians on her team offered hospice. My grandfather (her only son), declined fervently. Instead, he insisted on moving her back home to my aunt’s house, where my great ...

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The last thing Jessica said to John, her fiancé of 10 years, was, “I love you” before he drove to work. Hours later, after suddenly experiencing a cardiac arrest at the office, he was in an ICU bed attached to a ventilator. He was pale and unresponsive, on multiple medications to artificially augment his blood pressure, hooked up to a machine that did the work of his kidneys, and cooled ...

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 In today’s increasingly technological, data-driven, depersonalized world of health care, I wonder if the concept of “a good death” is even possible. The COVID-19 pandemic, in particular, has caused me to reflect on this. What does it look like? How do you define it? As I did, a patient came to mind. He was a retired minister in his 80s. I had cared for his wife as well ...

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"We are health care workers. We are doctors, advanced care practitioners, nurses, pharmacists, social workers, and so much more. We are on the frontlines. We are our parents’ children, and we are parents to our young children. For the first time, we are at an extremely high risk of being quarantined by the same beast we are trying to conquer. We ...

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"It seems as though the looming reality for many of us is that we will have patients who need ventilators, and none will be available. It seems like we might benefit from remembering that we can still succeed in practicing medicine by being present with those suffering before us, even when we know we cannot cure them of disease. In a more ...

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My medical school’s secondary application, like that of many other medical schools, asked me to describe a personal or professional challenge or conflict and to explain how I worked to resolve it. However, unlike other medical schools, my school specified that they did not want to hear about the MCAT or another academic challenge. For this question, I wrote about a challenge that I have been facing for most of my ...

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  "Faced with the prospect of not being able to provide all COVID-19 patients with the life support that they may need, physicians and nurses are working in conditions that have been described as 'hell.' How are providers to cope with the trauma they are experiencing in New York and Italy, and presumably other nations as well? How are they to cope with ...

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Death. Mortality. End of Life. Something inevitable, yet rarely discussed and a source of intense discomfort for most. When mentioned, it is considered inauspicious and rude in many cultures. Death is an integral part of the workday for a critical care physician like me. But it was never a topic of discussion in medical school or training. Death is inevitably encountered by every physician at some point and by every human. ...

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Life may never be the same after COVID-19.  With tens of thousands of Americans having succumbed to the coronavirus in the United States, some of us are considering our own mortality.  Life insurance companies have plenty of new customers.  Estate planning attorneys are busier than ever.  Many of us are thinking about how our loved ones will be taken care of in the event of our own death. Death is always ...

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I'm a palliative care chaplain who provides spiritual support to patients with serious, life-changing, and for some, life-threatening, illnesses. A common story they tell is an illness, like a storm, blew them off their life's map.  They find themselves lost in the unfamiliar territory of sickness. The future, once certain and promising, is now uncertain and ominous. Plans they'd made are on hold, possibly canceled. The specter of death looms ...

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Insurance companies require doctors to ask dozens of questions and click on carpal-tunnel inducing boxes during a yearly physical. However, none of those questions or boxes address one of the most important aspects of a person’s life, their death. So, as a family doctor, I encourage people to think about it, have “the conversation” with loved ones, and complete the paperwork. I’m also married to a doctor, so the conversation is ...

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I have cared for them both, husband and wife, now in their 80s, for almost 20 years. She is a retired nurse and him from his business. They are so typical of this “greatest generation”: tough, enduring, hard-working, deeply faithful, fervently independent, those characteristics that allowed them to survive the Great Depression, World War II, and the many challenges that come with life. They have seen their share of joy ...

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The doom, gloom, and uncertainty surrounding the ongoing COVID-19 pandemic can be overwhelming, even for an emergency department physician such as myself. The heaviness of the situation largely stems from the deadly nature of the virus, our relatively minimal understanding of how it works, and our seeming inability to control the rapidly changing nature of our day-to-day lives. TIME Ideas published an excellent piece by Drs. Jessica ...

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When coronavirus exploded, my family was on vacation in Colorado. We played the news nonstop, and it was frightening. I’m a control freak, a planner, and thus my worries were nonstop. What were other hospitals doing to prepare as compared to my own? What were the plans to ration PPE? How was the morale at the place I'd been at almost daily for years? I was angry, frustrated, and disappointed. Not ...

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Many of us are learning and refreshing our knowledge of critical care and vent management, but how about acknowledging that one of the most meaningful aspects of the art of medicine is simply to bear witness to, and ease the suffering of our fellow humans? So much energy of modern western medicine is fixated on achieving a cure, and so many of us are trained nowadays to follow an algorithm to ...

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The image of patients dying in the intensive care unit is changing. Over the phone, family members cry on the other end as I tell them that we are not allowing visitors due to “the coronavirus” at this time. They tell me, “but I help make his decisions for him.” These decisions now have to be made over the phone. This is just what we have to do to keep society ...

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Being a medical student during your clinical years imparts a certain feeling of invincibility. For many of us, this is our first-time taking care of patients. Our history-taking and physical exam skills are being honed like superpowers. Our clinical knowledge is growing. We begin to take ownership of patients as our own. With all but two clinical rotations left in my third year, and at the peak of my own feelings ...

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