An etiolated octogenarian calls out,
Barely audible beyond his room.
He beckons for a small sponge
To wet his cracked blue lips.
Pictures of his family are taped to his closet,
A makeshift fifty square foot home. ...continue reading →
When Canada’s Supreme Court struck down the law prohibiting the provision of assistance to someone committing suicide in February last year, I wrote a column welcoming this ruling. That led to an invitation to address the Annual Conference of the BC Palliative Care and Hospice Association in May 2015 on the topic of ‘healthy death’.
More recently, I have collaborated with Dr. Douglas McGregor, Medical Director of the Victoria Hospice, in conversations with hospice staff and volunteers from Victoria and across Vancouver Island. Our topic was physician-assisted death (PAD) and the dilemmas this poses for the people who work in hospice and palliative care.
I am very clear that a ‘healthy death’ is one that enables someone to have control over their way of death. ...continue reading →
I hate the way some people die
When no one's there to scream or cry
I hate the way they die alone
As I stand nearby, face turned to stone
I know I can't cry when they die
I shouldn't feel this. It isn't right. ...continue reading →
Domhnall MacAuleyis a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK
Could cancer simply be due to bad luck rather than environmental factors, risky behaviour or bad habits? In recent weeks, media attention focused on a scientific discussion on the risk of cancer based on papers published in Science and Nature. While the discussion itself is fascinating, isn’t it interesting that this debate took place across mainstream scientific publications rather than in established medical journals. Perhaps medicine is already convinced by the epidemiology or, maybe medical journals are less open to such debate. This is the story: ...continue reading →
Anthony J. Caprio, MD, CMD serves as the medical director and an Associate Professor for the Division of Aging, in the Department of Family Medicine for the Carolinas Healthcare System, Charlotte, North Carolina
The release of the IOM report was regarded by many U.S. healthcare professionals as a significant step forward in identifying gaps in the delivery of care for seriously ill and terminally ill patients. Specific recommendations were outlined as a “call to action” to improve end-of-life care. Hospice and palliative care physicians, in particular, rallied behind the report. ...continue reading →
Fred Burge is a Professor in the Department of Family Medicine at Dalhousie University, Nova Scotia.
Finally, a plenary session at NAPCRG on dying. For over twenty years I’ve come to this annual meeting as ‘the’ place to be nurtured as that oddest of breeds in medical research, a family doctor. Early in my academic life I thought I wanted to be a full time palliative care doctor. But over time I realized I loved long relationships with patients, sharing their experience with illness, helping them stay healthy and most compelling to me was being with them at life’s tough moments. What I call the transitions. New heart attacks, the diagnosis of multiple sclerosis, cancer diagnoses, depression, relationship challenges and so much more. Being a palliative care doc seemed only to work at the end of all of this. So, I moved back to being and loving family medicine. ...continue reading →
The curtains were drawn, I walked into the room,
Looked at the lady, and said, “How do you do?”
She was very kind, just a little bit addled,
But the doctors around us were really quite baffled
Had she had a stroke? Was it from the MVC?
There was nothing at all to see on the multiple CTs
Save a little bit of shadowing, in the corner over here
But the pictures were too blurry. No, not a single thing was clear!
So they made a few calls, and then made a couple more
They met with the consultants on every single floor
They put their heads together, and came up with an answer
“It’s so obvious!” they said. “She has metastatic cancer!” ...continue reading →
Domhnall MacAuley is a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK
At Dotmed2014 “The creative medical conference” everyone present seemed to be just a little bit different, both on the stage and in the audience. There were artists, musicians, poets, novelists, doctors and patients. Muiris Houston, doctor, journalist, and joint convenor of the conference, said it was designed to explore that space between medicine and humanity. But, it was also empowering, entertaining, stimulating and mind bending.
When she saw the blood on the glove she knew it was time to create a fuss. Not everyone does a rectal examination on their dad, but his blood pressure was dropping and the medical staff were not taking enough notice and someone had to look for a cause. Stories grab attention and when Dr Louise Aronson from UCSF told a gripping story of her father’s stay in hospital she showed that doctors, just like patients, respond well to narratives. For those of involved in public medical communication Aronson said, “the communication ecosystem has changed” and she gave five tips: ...continue reading →