He was 63 years old, admitted for septic shock from pneumonia. He had just been diagnosed with diffusely metastatic gastric cancer, and his family wanted chemotherapy started immediately.
I walk up the steps of the front porch. Halloween decorations adorn the steps and door. A witch, Jack o’ lantern, and a big spider on a web are placed just perfectly so, and ready for the festivities of the coming day. I enter and hear the tapping of a dog’s nails as he trots across the room to come greet me. His tail wagging; his fur is soft. I feel the dog licking my hand and I smile.
Nov 29, 2022
by Melissa C Palmer, LCSW, ACHP-SW, APHSW-C, JD
First and foremost, shame is a UNIVERSAL emotion. We have all felt shame at one point or another. However, we hide our shame because of the underlying fear that acknowledging those dark, imperfect parts of us will cause us to be shunned from our community and our people. As a result, shame festers and grows when it is held in secret isolation.
Nov 15, 2022
by Melissa C Palmer, LCSW, ACHP-SW, APHSW-C, JD
As we move toward the darkest time of the year, now is a good time to take stock, slow down and be introspective. We all have both light and darkness in us.
Nov 8, 2022
by Christine Merchant MSPC BSN RN CHPN
I recently read a book from my book group called “Golden Girl” by Elin Hilderbrand. The main character, a successful author, living in Nantucket is a single parent with 3 children ages 17 to 26. Early in the book she was the victim of a hit and run passing away.
My Mom died last month of a progressive lung disease that took a sudden turn for the worse. I was so lucky in that she was cared for in her last days by the inpatient palliative care team at my hospital and to meet some of my colleagues. Those colleagues were quick to tell me how resilient and gracious my Mom was.
Oct 25, 2022
by Chaplain Nikki Kleinberg, M. Div., BCC
This summer a landmark article in the field of Spirituality and Health literature was published in a prestigious medical journal with large readership, JAMA. As a Spiritual Care Subspecialist (Chaplain) in a high-volume Level I trauma center and tertiary care hospital, my thoughts and feelings are stirred by such high-quality evidence for the clinical value of human spirituality, and I wonder how institutions might apply such evidence to standard practice.
I never expected to be caring for my mother on home hospice during the course of the MSPC program. Although it was the most difficult thing I have ever done and be a part of, there was nowhere else I wanted to be than with her. Having left my spouse, two dogs and employment, I traveled 1,700 miles away and returned to my childhood home.
“Really? So, you’re just killing people? Aren’t you a doctor?” That was the reaction from family when I expressed my interest in becoming a Palliative Care specialist. Growing up in Indian culture, career goals are already set for you by your parents. “Doctor, Lawyer, or Engineer, pick one...”
When I transitioned to a role as a palliative care program coordinator 6 years ago, I had a lot to learn about hospice and palliative care, so I googled the meaning of the word “hospice.”
We so often hear about the problematic aspects of social media. I know that I have anticipatory worry about its effects on my kids, who are still too young to engage with it. About once per month, I toy with the idea of taking a break or quitting it altogether. However, I have recently realized that for me, Instagram has been a surprising tool to help boost my morale, connect with others struggling as health-care providers in a global pandemic, recognize early signs of burnout before they become overly problematic, and cope in a complicated world.
I am often reminded of poems as I go through life. Sadly, being a hospice doctor tends to bring to mind painful, troubling strophes more often than those that are hopeful, upbeat or humorous. Song lyrics (a form of poetry) like those from "Elephant," by Jason Isbell, play in my head on many a workday, when I am weary of demoralization, denial and existential dread, of patients who are too young and families that seem incapable of grace.
Prior to February 2020, I never heard of perinatal palliative care. Perinatal palliative care is medical services offered to families who learn that their baby is going to die before or shortly after birth. Parents often find these services after they decide to continue a pregnancy following a prenatal diagnosis of a life-limiting condition. I wish I knew more about these services after receiving my prenatal diagnosis for my daughter.
The 1989 film, directed by Spike Lee, is enjoying a comeback this summer due to its relevance to today’s Black Lives Matter movement and a resurgence of violent, racially motivated attacks. I was reminded of the film by a flyer posted in my hometown theater announcing it would be featured as part of a community forum on diversity. “Wow!” I thought. But exactly what does it mean—“Do the Right Thing?”
POST GRAPE-NUTS remind me of palliative care. Parts of it have a naturally sweet taste. Coinciding with my professional ascent into palliative medicine and our collective descent into the global exercise of social distancing, I find myself pondering more at the supermarket.
I never thought my professional duty and clinical practice would intersect with my belief in a pregnant person’s right to an abortion. Given the scope of my first 12 years in medical practice as an otolaryngology head and neck surgeon, my professional care of pregnant people seemed to be from a side-line role. The scenarios did not endanger the life of the pregnant person.
Mr. F is stoic. He sits quietly, peacefully, Buddha-like. He has intrinsic dignity, and his wife is intent on preserving this. She has so few gray strands in her hair that it is hard to believe that she is 89. I will have a family meeting next week with this family. I will not win; this pleases me because I do not want to win this argument.
Four score and 6 years? Only an 86-year-old man is likely to know that a score is 20 years. Is this from reading the Bible or memorizing the Gettysburg Address when he was a child in school? Although I wonder if one of the most famous bits of American oratory would have been taught in the Heart of Dixie?
Mr. K had been sick for a long time. Although he had dementia and thought Nixon was president, he did remember that he had Multiple Myeloma for 14 years. That is a long time for a disease that's average life expectancy is 3-4 years. Few people live more than 5 years.