Telemedicine should never replace in-person care, especially in the patient-centric hospice environment, but when used appropriately it can provide benefits not found in any other care environment.
In retrospect, I regret that she was not allowed to die peacefully. I now am compassionate towards those who opt solely for palliative management in terminal illnesses.
He was sick, but it wasn’t like he was going to die anytime soon. A year ago, my dog Sierra sustained a neurological insult that left him delirious, unable to walk straight and almost entirely blind and deaf.
In today’s America, it is well documented that each year, more of our GDP is being devoted to healthcare spending, and a disproportionate amount of that healthcare spending is towards end-of-life care. According to a 2013 report from The Medicare NewsGroup, Medicare spending reached about $554 billion in 2011. This was 21 percent of the total spent on health care in the US that year. About 28 percent of that $554 billion — $170 billion — was spent on patients’ last six months of life.
The traditional structure of medical education begins with teaching normal anatomy and physiology followed by the various pathologies and treatments. Once students reach the clinical years, we are taught to think in the form of a SOAP note. First, perform a history and physical; then, order the necessary diagnostic tests to obtain your subjective and objective information. Next, form your assessment and plan — what is the problem, and how do you fix it?
To my dearest dying patient: / May I emulate half your strength, / and a portion of your wisdom, / just a part of your life’s length.
A flannel button-up and house shoes wear a man / Sitting to my left, with a right ear just trying to keep up appearances; / Just as deaf to the / echo of firework safety / Then, / As to my voice / Now.
Whenever someone hang glides, / They pick a place to land. / Somewhere soft and somewhere close, / Somewhere that they planned.
After a nearly 40-year moratorium, a controlled study of the therapeutic use of LSD in humans has been published in The Journal of Neural and Mental Disease after the pioneering work of Swiss psychiatrist Peter Gasser. Sponsored by the Multidisciplinary Association for Psychedelic Studies (MAPS) and approved by the BAG (the Swiss Drug Enforcement Agency), the study has completed treatment of all subjects after having enrolled its first patient in April of 2008. Many hallucinogens, such as psilocybin and MDMA, are being investigated today for their clinical benefits as a result of a gradual effort to reexamine the pharmacologic and psychiatric interests in hallucinogens.
Mr. Lacey was irate, to say the least, as he rattled off a list of his symptoms. Constant pain. Nausea. Dizziness. Numbness. Weakness. Fatigue bordering on exhaustion. He said he had been spending most of the day in bed and had become dependent on his wife and children for basic daily tasks. “I’m serious, Doc. I’ve just about had enough of this. I’ve been looking into Hemlock Societies.” The interview screeched to a halt, and …
She had not been home in at least three days. She sat motionless, shoulders slumped, arms draped limply over her lap. I couldn’t tell if she had nodded off. The wrinkles of her clothes seemed to blend into the lines of her face, stuck in a soft, yet permanent frown. The red of her blouse appeared faint against her pallid skin, as if exhaustion had sapped everything it could from her being, and had moved …
The epicenter of the debate surrounding costs and utilization of health care is on end-of-life care. A full one-third of Medicare expenditures are spent on chronic illness patients in the last two years of life. For perspective, consider this graph: our costs of care are comparable to those of European countries for the first five decades of life, but we spend twice as much on people in their sixties, thrice as much on people in their seventies, and over four …