Blog

Providers are just as guilty of missing the big picture as patients and families. a Patient Mr K, 78 yrs old, has long been dealing with multiple health issues.  His everyday life consists of treatments for diabetes, coronary artery disease, congestive heart failure and chronic kidney disease.  And about a year ago, he was diagnosed withRead more

The presence of personal photos or other items from home can make the hospital setting a more comforting one for patients.  This can be particularly helpful for patients with long, unexpected hospital stays, such those patients critically ill in a ICU setting.  And for elderly patients, bringing familiar items to the unfamiliar hospital, may help fendRead more

more teachings from Mrs G and her family. In my previous post you met Mrs G. Her hospital course was marked by periods of instability, followed by a few days of relative calm, and on occasion, a few days of actual improvement.  Then, another setback.   Taken as a whole, her trajectory was one of overallRead more

much like jack nicholson said to tom cruise in the movie ‘a few good men’, I sometimes  wonder if providers feel that patients/families can’t handle the truth… Because I often witness them describing very serious issues, such as a terminal diagnosis or the potential burdens of high-risk procedures/treatments in ways that obscure their true nature. WhetherRead more

A few years ago, I authored a ‘letter to the editor’ published in the journal Transplantation.  The topic:  the utility of including palliative medicine providers in the world of transplantation- specifically, liver transplantation.  Since patients awaiting liver transplantation are truly the ‘sickest of the sick’, if there is any group of patients who could potentiallyRead more

They say a broken clock tells the correct time twice a day.   I guess that’s can apply to terrible medical articles in the lay press as well. During a discussion about a patient with complicated medical issues, my colleague mentioned that she believes that a patient’s code status can impact the way they are treatedRead more

Mrs T, 65 yrs old, has lived with multiple sclerosis (MS) for over 20 years ago.  Her course has been one of intermittent exacerbations with intervening periods of stability.  Over the past few years, she has become quite frail and requires caregiver support for day to day activities. She was recently admitted to the hospitalRead more

This has nothing to do with the theme of my blog, but I want to share it here none the less. A few years ago, i listened to Mr. Bryan Stevenson speak at the Dallas book festival.  His book Just Mercy had recently been published- and he talked humbly about his life and tireless work at theRead more

“at least I don’t have cancer” That’s what Mrs G said soon after being diagnosed with congestive heart failure. But as her provider, before you offer her tacit agreement (because you think that’s being empathetic- but, sorry, it’s not) while continuing on with your visit, take a moment to pause. What is she really saying?Read more

for his induction into the Canadian Medical Hall of Fame, april 12, 2018. some background Initially trained in urology, the talented surgeon/educator/researcher never thought much about death or the process of dying- he just assumed that as a doctor, he of course knew everything.  But then he did something that would change his entire careerRead more