Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Latest Posts

Understanding Your Hospice And Palliative Care Options

Prepared Patient - Hospice Care: What Is It, Anyway? Seeking Shelter

The word hospice originated from the Latin hospitium, which means “to host or offer a place of shelter.” In 2009, an estimated 1.56 million patients, more than 40 percent of deaths, received hospice services in the United States. But many others who might have benefited from hospice care did not seek services, perhaps due to misconceptions, fears and the lack of information of patients, caregivers and even physicians.

“Hospice is a collection of services that are designed to support the patient and family through the course of a serious or terminal illness,” said Donald Schumacher, Psy.D, president and CEO of the National Hospice and Palliative Care Organization (NHPCO). The aim of hospice is to provide physical and emotional care and comfort in the months, weeks and days before death.

It’s often hard for patients and their loved ones to acknowledge that the time to consider hospice care has come. People come to that realization differently and there are some that might never seem to face that the end of life is near. But through the ups and downs of emotions and physical status, hospice team members Read more »

*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*

May We All Die So Well

Everyone liked him. Though his later years (the only ones in which I knew him) took away his ability to do most things, and though he was in great pain every day, it was easy to see the mischief in his eyes. The subtle humor was still there, coming out of a man who was weak, in pain, dying.

She lived for him. She was always telling me of his pain, frustrated with the fact that he didn’t tell me enough. She was anxious about each complaint of his, wondering if this was the one that would take him away from her. Many of her problems were driven by this anxiety and fears, and she spent many hours in my office giving witness to them through her tears.

As his health failed, I wondered about her future. He was the center of her life, the source of her energy, joy, purpose. How could she manage life without him? How could she, who had so much lived off of the care of this wonderful man, find meaning and purpose in a life without his calming presence?

Then he died. Read more »

*This blog post was originally published at Musings of a Distractible Mind*

Is There A Rule Book On Grief?

She looked down toward her feet at the end of her visit. “I’ve got one more question, doctor,” she said, hesitating. I turned toward her and waited for her, letting her ask on her own time. Clearly this was something difficult for her to ask.

“When will I get over the death of my husband? It’s been ten years, and I still wake up each morning thinking he’s there. I still come home wanting him to be there. Am I crazy?”

Her face showed the shame that was so clear in her words. I had been along with her during the death of her husband, and she handled that period with much grace and strength. Now the silence at home is deafening. People around her, on the other hand, are far too quick to tell her how to grieve. Read more »

*This blog post was originally published at Musings of a Distractible Mind*

The Right To Mourn

Grief and lossI seem to have had a run on bereavement recently, in that I’ve had several patients who have lost loved ones. Some have wound up in my office for unrelated complaints, only to have the grief spill out. I’ve become aware of the struggles of others via Facebook.

I’ve found this handout (from Family Practice Management several years ago) to be very useful. I keep copies in my office and hand them out when needed, but it occurs to me that having another way to disseminate this helpful information would be a good idea. Read more »

*This blog post was originally published at Musings of a Dinosaur*

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…

Read more »

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…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

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…

Read more »

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…

Read more »

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…

Read more »

See all book reviews »