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Considering Tuesdays With Morrie When Facing A Life-Threatening Diagnosis

Film adaptation of "Tuesdays with Morrie"

Many of you know about, or have read, the highly recommended book, Tuesdays With Morrie. I am reading it now with my 14-year-old son, Eitan, as part of an assignment for his ninth grade English class. Morrie, a college professor in Boston, was dying, withering away with ALS. Each Tuesday he would have a visit from one of his favorite former students, Mitch, a journalist from Detroit. Morrie, a man in his 70’s, mused about many things including the meaning of life and the inevitability of death. He was prepared for his end.

The other day I spoke about that book with a former high school English teacher – not Eitan’s. The circumstance was not good. The woman, 37, had been diagnosed with stomach cancer just six weeks ago. She’d been having heartburn and it wouldn’t go away. Endoscopy showed the cancer and other tests revealed its spread to her liver and lung – stage 4. The woman and her husband, her high school sweetheart, sat across from me at lunch. They have three young children, age Read more »

*This blog post was originally published at Andrew's Blog*

Study Shows That Knowledge Of Imminent Death Is Beneficial For Cancer Patients

Providing information of imminent death to cancer patients does not increase pain or anxiety, but is associated with improved care and to increase the likelihood of fulfilling the principles of a good death, a Swedish study found.

Informed patients significantly more often had parenteral drugs prescribed as needed, died in his or her preferred place, and had an informed family who were offered bereavement support. There was no difference between informed and uninformed patients in control of pain, anxiety, nausea, and respiratory tract secretions, although there was a difference in management of confusion. Results appeared in the Journal of Clinical Oncology.

Since 2000, there has been an increasing focus on palliative care in Sweden, the study authors wrote. In 2001, the Swedish Government identified breakpoints for Read more »

*This blog post was originally published at ACP Hospitalist*

A Poem About An Ending

She coughs
and heaves a breathless goodbye
into the bedside phone.

Her lungs
damp, bloated, sacked honeycomb
wheeze with vanishing bees.

The room
of sensors and startling noise
has not air to float upon.

slakes a thirst for breathable sky
and calms the panic within.

The shame
of living, of death smiling,
savoring smoke and ash.

Eyes closed
she imagines her son, boy,
man, precious evermore.

Beautiful white, red, and black
from a husband who waits.

spinning in galaxies far,
with summer lightning bugs.

And then
it is upon her, the moment,
dreaded, practiced, boundless.

We run
through soft sands lit by moonlight,
now tumbling under waves.

All that matters
And all that happens

The absence of pain and hunger
the end of struggle and story
mark an indifferent,
yet decent,

*This blog post was originally published at The Examining Room of Dr. Charles*

The Beauty Of Life And Death, Too Easily Forgotten

Yesterday I had a university student shadowing me in the emergency department. AF is a bright student, a hard worker who will make a wonderful physician. She is always curious and insightful when I ask her questions, or show her new things. Today,  she saw something that was new for her, but perhaps too common for me.

I walked into the room of an infirm, frail old gentleman who was gracious and polite, as was his family. It turns out he came to us with a terminal illness. I did not know it, but his physician was meeting him. So, as AF and I walked into the room, the patient’s physician walked in after us, and continued a conversation about hospice that he had apparently begun earlier in the day.

Realizing I had nothing to add, and would not be needed, I slipped away with my shadow behind. She looked at me, tears welling, and excused herself. Later she returned and explained that when she saw the wife’s wedding band, and knew what hospice meant, she could not restrain her tears. Read more »

*This blog post was originally published at*

When Grief Turns Into Rage

Twice in the last few months I have encountered grief as rage. Both were in the setting of the cardiac arrest of individuals who were already very ill. One was aged, with severe, end-stage heart disease. One was of middle age, but with metastatic cancer and on hospice.

In one instance, family members became angry because we did not leave the body in the ER for eight hours so that everyone could come and pay their respects. (Which I always thought was the purpose of a funeral home.) 

In another, a family was angry because we did not allow everyone back into the room during the resuscitation of their cancer-stricken loved one — a resuscitation the family insisted upon, and which required rescinding hospice status. From observing their demeanor, their presence would have caused total chaos. Read more »

*This blog post was originally published at*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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