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 — but this ...

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“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 ...

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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 ...

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The day began in Mom's room with a 10:00 a.m. conference at Upper Valley Medical Center, west of Columbus, Ohio. In attendance were my 93-year-old mother Joanne (now in her third week of hospitalization), her palliative-care nurse Richard, her Episcopal priest Mother Nancy and myself. Mom was on high-flow oxygen therapy delivered through a nasal cannula. Despite this, her blood-oxygen levels were well below normal. Clearly, her lung function was declining. ...

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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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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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