palliative care

Palliative Care and the Lost Art of Communication

The following is Part 2 in a series about end-of-life care. For Part 1, see here. This article addresses my own experience on a Palliative Medicine elective in my fourth year of medical school.

Despite the growing number of U.S. hospitals with Palliative Care teams, there remains a real lack of understanding about the benefit that specialized Palliative Care providers can bring for patients with advanced illness. This form of care is especially valuable in patients with end-stage illness (and has even been shown to extend life by several months), but it can also help any patient at any stage of illness (regardless of prognosis). Indeed, even prescribing an NSAID for headache can be considered a form of palliation. The focus is about improving quality of life now instead of later. (more…)

Medical Students Don’t Learn About Death

The following is part 1 in a series about death and dying in the medical context. This reflection was written by me earlier this year, before I sought out a Palliative Medicine elective. Part 2 will follow soon.

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Until the last week of my sub-internship, I had never had a patient die on my watch. To be sure, I had patients on the cusp of dying – and some who did die, of course, when I was already on another rotation. I have been around dying patients who were on our team but were being taken care of by the other resident/medical student. But never a patient of my own, until my final year of medical school.

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I can’t let my patients see

I almost broke down in the theater tonight.
I fought back tears as the main character tried to navigate a confusing, capricious world.
I fought back tears when his parents argued about how best to care for him.
I fought back tears as he bravely sought answers to tough questions.
I almost broke down in the theater tonight.

I started an elective in Palliative Care last week.
I remained supportive but stoic as my patients tried to navigate a confusing, capricious existence.
I remained supportive but stoic when their families worried how to best care for their loved ones.
I remained supportive but stoic as they bravely sought answers to tough questions.
I started an elective in Palliative Care last week.

I almost broke down in the theater tonight.
I can’t let my patients see.

It’s the only model I have learned.
This is how a doctor behaves.

Right?