We're all gonna die. It's a simple truth that an astounding number of people neglect to acknowledge or accept. Some people die sudden, unexpected deaths, but most eventually fall victim to chronic or terminal conditions like COPD, heart failure or cancer. As a palliative care physician, I often meet patients who have had conversations with their families about their end of life wishes and have completed supporting legal documents. While I appreciate ...

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I left a full-time academic position five years ago because I was literally, “check-all-the-boxes,” burned out. In looking back during that time prior to my decision to leave, I recall months of feeling overwhelmed, emotionally exhausted, depressed, and in a sense grieved for the loss of what I envisioned my career path to be until retirement. It was not until one of my favorite patients, Mr. Young, who knew me ...

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"Let's start the powwow," a man with a brown jacket and braided ponytail said with a smile. Nineteen adults and one child filled the back conference room of the hospital. The hospital had made an industrial cylinder of coffee for the meeting, and it was almost completely drained. I hung the stethoscope around my neck, knowing I wouldn't use it as anything but a prop to signify my training and ...

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I’ve been a doctor for a bit under a year now. I am a family medicine intern, working in blocks at a city hospital, wearing a lot of different hats. Sometimes I’m on the labor and delivery floor, helping new lives begin; sometimes I’m on the family medicine service, caring for ill patients who may be dying. Some of the moments that have stuck with me the most this year ...

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I’ve always thought that I’ve understood illness and mortality very matter-of-factly. You live your life, you’ll most likely end up with some medical conditions along the way, and ultimately everyone’s life will come to an end because the body is not designed to function indefinitely. And do I cry at every funeral I attend? Absolutely. I understand physiologically and pathologically why things happen, but also realize human relationships will always ...

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Sometimes referred to as "right-to-die," "physician-assisted suicide" laws make it possible for terminally ill patients to use prescribed medications to end their lives instead of facing a protracted death. The latest state to pass legislation allowing terminally ill patients to end their lives was New Jersey. The law will go into effect on August 1. The topic of physician-assisted suicide and right-to-die is incredibly complex and emotionally charged. I'm not going ...

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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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