Pallimed

noreply@blogger.com (Alex Smith) — Sun, 07 Apr 2013 03:15:35 +0000

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I want to say how sadden I was to learn San Diego ...

noreply@blogger.com (Anonymous) — Sat, 16 Feb 2013 22:19:10 +0000

I want to say how sadden I was to learn San Diego Hospice was closing. My husband was in San Diego Hospice during his finally days in June 2007. I did not quite know what to expect when we first arrived at hospice after a few rough hospital stays. I was amazed at the care he and I received during and after his death. The doctors nurses and the entire staff were our angels their compassion and respect they showed was exceptional. After his death I continued with grief counselling. Hospice care got me through a very difficult time in my life and I will always remember hospice as my angels. Thank you for all hospice does for patients and entire families

I can see the several points of view here. This p...

noreply@blogger.com (George Handzo) — Thu, 28 Jun 2012 22:40:38 +0000

I can see the several points of view here. This points out the limit of having to communicate to our "public" through YouTube and Twitter. There is no good result here. Closing the window or leaving it open are both "open" to critique. I agree on balance that the take home is helpful. However, it points out that we need to be very careful and have lots of help as we continue in this new land of social media.

I have to disagree about the benefits of F2F. I a...

noreply@blogger.com (John Bohlen, MD) — Thu, 28 Jun 2012 15:22:50 +0000

I have to disagree about the benefits of F2F.

I am a rural MD, I am the only MD in our organization. Roughly 20% of my time with Hospice is devoted to F2F visits. I have seen no "better approach to patient care with the actual experience of seeing a patient beyond the chart information."

The reason that we "have managed to adopt to this task without significant problems" is the willingness of the Hospice Medical Director to work overtime, away from duties that would actually benefit patients (and family).

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Happy birthday, Pallimed. I did not get you a pre...

noreply@blogger.com (Thaddeus Mason Pope, JD, PhD) — Thu, 14 Jun 2012 00:38:08 +0000

Happy birthday, Pallimed. I did not get you a present. But I appreciate the g"gift" of your excellent blog. -- Thaddeus Pope

I agree with the "ask the child" stance....

noreply@blogger.com (George Handzo) — Wed, 02 May 2012 10:29:34 +0000

I agree with the "ask the child" stance. I've seen children under 5 cope very well with funerals- even when the deceased is one of their parents. Just like with adults, it is essential for the child to be fully informed about what to anticipate before being asked to make a decision. A couple of other ideas. (1) Bring them to the site of the funeral early so they can get used to the setting without having to cope with the crowds. (2)Have a dedicated person with them who they are comfortable with, who is there just for them and who is willing to leave with them at any point where the child has had enough. George Handzo

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Thanks for posting this. I shared it on Facebook ...

noreply@blogger.com (Viki Kind) — Mon, 20 Jun 2011 20:17:56 +0000

Thanks for posting this. I shared it on Facebook and LinkedIn. It unfortunately represents the many bad deaths where people aren't given the option of palliative care and hospice. These situations are exactly why I do the work I do.

Lyle—thanks for raising the issue of the “war meta...

noreply@blogger.com (Denise H) — Sun, 29 May 2011 15:39:21 +0000

Lyle—thanks for raising the issue of the “war metaphor.” While I too applaud Mr. Killebrew’s openness in speaking about his transition to hospice care, I also find the battle language problematic.

I could never quite put my finger on what bothered me about the battle language until I came across Walt Wangerin’s reflections in his book “Letters From the Land of Cancer.” Wangerin recognizes that to frame his cancer in terms of a battle (something which it seems everyone around him expects and encourages him to do), is inherently unsatisfying since the cancer is a part of his body, “supported by my blood and my oxygen, of the same substance, if not of the same structure, as other body parts” (33). For Wangerin, if there is a battle, it would be against his own body. Star Wars, good v. evil metaphors fail if the “good guys” are actually helping the “bad guys.” I suspect that this is why so many people with cancer express feeling betrayed by their own bodies. I also suspect that the battle language can act as a sort of refuge from the more uncomfortable feelings of vulnerability, fear, lack of control and isolation that come from recognizing that the “enemy” is inside not outside.

But what are the alternatives? If President Obama were to re-work President Nixon’s “war on cancer” what new language should he use? I have heard “dance with cancer” (who would want that dance partner?) and the ever-present “journey” motif (starts to sound very Hallmarkian), but have yet to hear of a compelling alternative. Ideas anyone?

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Lyle- Nice article and great post. I don't re...

noreply@blogger.com (Clay M. Anderson, MD) — Mon, 16 May 2011 17:30:47 +0000

Lyle-
Nice article and great post. I don't read the sports section carefully at all but this article had screamed out at me yesterday and I had cut it out and taken it in to my hospice this morning. I just feel like a proud papa when celebrities who could buy any treatment they want choose hospice enthusiastically when they want to focus on being home, relief of symptoms, life review, and acts of pleasure during their last weeks of life limiting chronic illness (having had to face and accept untimely death). Many do, but few publicize their journey during this phase, as you say. Would be a great, heart-rending and heart-warming special feature or ad campaign to have the general public hear a bunch of these stories together. I feel the transition to comfort care from broader palliative care is very important and best to be clearly demarcated, with as much palliative care mixed and matched with disease directed interventions as the patient desires prior to that critical transition. Hospice/comfort care is best when personalized, demedicalized, and domesticized, as it were, if possible.
thanks, lyle, and mr. killebrew!
clay anderson
north kansas city, mo.

Dan Sulmasy in this book, The Healer's Calling...

noreply@blogger.com (George Handzo) — Mon, 16 May 2011 12:02:37 +0000

Dan Sulmasy in this book, The Healer's Calling, makes the distinction between curing and healing. He characterizes healing as a "deeply human process" which requires relationships. So, while no one would denegrate curing as a worthy goal, maybe the ultimate treatment goal is healing which can hopefully often include curing. So maybe the shift to hospice which often feels so dramatic is not really a goal change at all, but simply a shift in tactics to continue the focus on healing.

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