"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 ...

Read more...

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. ...

Read more...

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 ...

Read more...

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 ...

Read more...

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 ...

Read more...

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 ...

Read more...

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 ...

Read more...

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 ...

Read more...

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 ...

Read more...

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 ...

Read more...

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 ...

Read more...

He was a logical man. A northeast Ohio man. Who worked all his life and worked hard. I can see it in his hands. They are entirely calloused with traces of grease impervious even to pumice soap. A family man. His wife and sons and daughters are at bedside. And proud grandson, just a man, not dry-eyed, stands in the corner, in his college jacket, the spitting image of his bedridden ...

Read more...

Does care fall short or go higher when the patient is one of our own? It depends on who you ask: We, the medical team, believe we try hard for everyone, but go the extra mile when it's one of our own. Perhaps to family/outsiders, we're not doing enough. A recent case illustrates this phenomenon: a gifted physician colleague, a new diagnosis of advanced cancer. Needs control as part of a coping ...

Read more...

We were told to wear masks before entering this patient’s ICU room. Entering his room, you could smell his rotting flesh. He was 92 years old. His skin would slough off if you dared to bathe him. His decubitus ulcers were raging with infection. As long as I’ve been an ICU nurse, this was the worst — the smell, the neglect, the disrespect for this man. He was VIP status. I always had a problem ...

Read more...

An excerpt from Death Is But a Dream: Finding Hope and Meaning at Life's End. Published on February 11, 2020 by Avery, and imprint of Penguin Publishing Group, a division of Penguin Random House, LLC. Copyright © 2020 by William Hudson, LLC Dying in the hospital is ...

Read more...

It's the winter of 1993. A cold, snowy day. Windy. A blizzard. The phone rings. I'm not on call for my patients today — except for one. Daisy has been in my care since the early 1970s, and given the risk that she may suffer a serious downturn, I've instructed her nursing home to call me whenever necessary. This is that call. Daisy, my dear lady, the old artist, is dying. Throughout her ...

Read more...

Google is universally well known as a search and advertising company. Now Google is tapping into the $3.5 trillion health care market. To compete with the Apple Watch, Google acquired Fitbit, the wearable exercise, heart rate and sleep tracking device. Data is king. Voluntarily worn fitness tracking devices are one thing, but Google has entered the realm of the brave new world. A government inquiry has ...

Read more...

Who remembers Jack Kevorkian, Doctor Death? He was found guilty in 1998 of second-degree murder. Still, it was because of his advocacy that the terminally ill patient's right to die by physician-assisted suicide was propelled into the public arena. And who can forget Brittany Maynard? It was her advocacy for physician-assisted suicide that reignited the debate on its legality in 2014 — ...

Read more...

“Black life remains unexpected.” I have been mulling over these words written by Ibram X. Kendi, in The Atlantic. This followed his piece exploring the “anniversary” of slavery in 2019. He experiences this 400-year marker both with hope and concern given the persistence of a split America: “Black death matters to racist America. Black life matters to African America.” He writes, “there may be no more consequential white ...

Read more...

My 83-year-old patient had outlived peoples' expectations on several occasions. Faced with a critical illness three years ago, she underwent emergency surgery and spent several months in the hospital with a series of complications, including septic shock, renal failure, and hospital-acquired pneumonia. I'd seen her in the office for a new visit soon after she was discharged. It took nearly 20 minutes to go through her history before walking into the ...

Read more...

22 Pages

Most Popular

✓ Join 150,000+ subscribers
✓ Get KevinMD's most popular stories