Returning from my week of vacation, I was greeted by the usual stack of mail, faxes, forms to be signed, throwaway journals, and a fully loaded group of in-basket messages that had piled up in the electronic medical record that needed attending to. One of the pieces of mail was an unsolicited package with a bright red label on it, along with ...

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On October 1, 2019, Nevada began allowing individuals to avoid living in late-stage dementia. The new statute recognizes the legitimacy of an advance directive that instructs health care providers to stop hand feeding food and fluid by mouth. Individuals have already been completing such directives in New York and Washington. The Nevada law is the first that explicitly authorizes such instructions. Growing ...

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I remember it was raining outside when I told Ester she had metastatic stomach cancer.  She cried, as her son sat silently holding one thin hand in two of his.  After a while, she asked, how long did she have to live?  I explained it depended on how well the chemotherapy worked.  She smiled gently, as one humoring a silly child, and said that there would be no treatment. After ...

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Clutching my duffel bag under my rain jacket, I dash from my truck toward a house that was built by Frankie, the man I'm here to give the last massage of his life. I've been massaging people since I was five and have been a professional massage therapist for 40 years. I don't make house calls anymore, but it's an honor to give a man the last massage of his life, ...

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Physician Speaking by KevinMD is the only physician-run, all-physician speakers bureau. We are practicing physicians and experienced keynote speakers, highlighting both large-scale events and intimate day-long workshops. Today’s spotlight physician speaker is Dr. Shoshana Ungerleider. (Please visit our previous spotlight speakers, Dr. David Geier, Dr. Jordan Grumet, and Dr. C. ...

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“Planned death.” When you put it like that, this can only mean one of two things: suicide or murder. For most of us in medicine, the very idea of “planned death” seems safely outside our purview. After all, the bulk of medicine is concerned with staving off death. And the very nature of death’s uncertain timing enables practitioners of everyday medicine to take refuge in its mystery. When necessary, we prognosticate. But ...

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I found you standing on a platform. It was a foggy, damp morning, and your vision was obscured. People came and went, some with urgency, others not so much. Some people you knew, others were strangers. Your husband was usually nearby, often holding your hand, other times out of sight. At times you could hear his voice, but couldn’t find him with your reach. There were noises that would startle you, ...

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Every morning, after rounding on Mr. Gregory, I felt like an imposter. As I reported on the worsening crackles in his lungs, his decreasing urine output, the mottling of his hands, we continued to simply give him Dilaudid for pain and continued to ensure that he was “comfortable.” In this case, I was at a loss for what this “comfort” meant. Mr. Gregory was the first hospice patient I had. And ...

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The way I learned the Golden Rule was: "Do unto others as you would have them do unto you." Basically, it's from the New Testament, but the concept goes way back to pre-Christian ancient civilizations in Babylonia, Egypt, India, and China. So here I am, just trying to do my best as a spousal caregiver, and I started to realize that if I were to take the Golden Rule literally — ...

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I, like many physicians, am the only doctor in my extended family. To say that they are proud is probably an understatement. I’ve been a practicing physician for seven years now and yet my grandmother each time I see her greets me with, “There’s my doctor grandson.” I have worked quite hard to get to where I am, and I enjoy what I do. I, too, am proud to be the ...

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