I am a nocturnist (a nocturnal hospitalist). I love my job, but many nights my work can seem unfulfilling. For one, taking care of hospitalized adult patients is primarily spent managing exacerbations of chronic diseases. Therefore, the reality is that most patients will not be cured, only managed. Additionally, there is the loneliness factor, the incessant beeping of my pager, and the fact that I am forced to disturb the ...

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My wife Uzma died peacefully at home. She didn't take any painkillers for her last three days. Our kids, my parents, and I were next to her. In the weeks leading up to her death, many old friends visited her. Others sent her flowers, cards, and food. It was a good death. Yes, in the last five years cancer and its treatment took a physical and emotional toll. Yes, she left us a ...

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Are you or a loved one aging, perhaps with a chronic heart or lung condition that limits daily activities? Do you have an older parent in a nursing home or who needs assistance with daily living activities? If so, read on and make the pledge. As physicians, we see death every day. We see death made worse and more painful by poor advance care planning. Yet, despite the certainty of death ...

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Studies show that when people know what palliative care is, they want it. Marketing genius Seth Godin talks about offering services that are “remarkable” — so good that a person would cross the street to tell a friend. Palliative care has that kind of value, so why doesn't our message travel upstream through word of mouth? Would-be evangelists are often flummoxed by the fact that the phrase has still has different ...

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“Grandma fell and we’re in the emergency room. She’s very distressed and does not look good. I’m going to put the doctor on the phone.” I could hear my mother’s voice strain on the other end of the phone line as I braced myself for my conversation with the emergency department physician. The emergency physician told me that though the work-up was still developing, my grandmother was in respiratory distress, and that ...

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I am certain that many of you might be familiar with the intelligent, vibrant young lady named Brittany Maynard. Brittany's story was so compelling to the world that it reached the most outstanding and historic numbers through digital media. Ms. Maynard was only 29, diagnosed with terminal brain cancer and decided that she would end her own life "when the time seemed right." Maynard was an advocate ...

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Brittany Maynard was diagnosed with grade 2 astrocytoma, a form of brain cancer on January 1, 2014, her cancer also returned in April 2014, where her diagnosis was elevated to grade 4 astrocytoma, also known as glioblastoma, with a prognosis of just six months to live. She decided to take lethal drugs prescribed by her physician to end her life on November 1, 2014, at her home in Portland, Oregon. Under Oregon's "Death ...

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It's Monday morning, and I'm the attending physician starting a week of inpatient service in the hospital. On my patient list is a man named Earl, age ninety-one. He's outlived his siblings, his first and second wives and all of his peers. After seven decades of smoking, his lungs are failing; he carries a diagnosis that reads "severe emphysema." The sign-out note from Earl's previous doctor reads: "Daughter and son-in-law met ...

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“For the rest of my life, I’ll never see her again or smell the scent of her unwashed hair. I’ll never hug her soft squishy hips or sigh when she tells me to stop sleeping, get up, and enjoy the day.” This runs through my head before I start sobbing in my car. Most of the time I feel fine, but when I confront the finality of my grandmother’s existence, tremendous ...

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"Before I leave, I want to talk to you about something very important. I want to make sure that nothing is ever done against your wishes, so it doesn’t matter if you’re 18 or 98 years of age, if you’re a patient being admitted to the hospital, I need to ask you some questions. You’re stable — so I hope I don’t alarm you with this discussion. Have you ever ...

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