Beatrice Preti is an Internal Medicine Resident (R1)at Queen's University
It was the strangest of days when I met him first
Everything jumping from awful to worse
People were shouting and crying and seizing
Coughing and choking and retching and wheezing
It was nearly twelve hours before I could go home
But the attending doc called direct on my phone
And asked me, please, could I see one patient more?
Well, I couldn’t say no, so I went back to the floor
And met him there, though, then, he was alive, But looking so dead I knew he hadn’t long to survive Yet I took the history, and wrote everything thing down
Signed the orders, made the calls, and finished my rounds
Tucked him in for the night, and was just about to leave
When he said to me, “Doc? How much time do I have, please?” ...continue reading →
is a medical student in the Class of 2020 at Western University
Nearing the end of my first year in Medical School, I am amazed by the wealth of knowledge acquired during such a short time. There have even been several moments throughout the year where picturing myself as a fully licensed physician seemed slightly less daunting. I have become comfortable with routine physicals, certain diagnoses, different drugs, and management of a wide range of illnesses. I have no doubt I will encounter each of these facets of healthcare during my career. However, there is one unavoidable aspect of medicine that has been discussed very little: death.
The discussion of death is, understandably, quite sensitive; thus, discussing it with such a diverse demographic of students requires a certain amount of skill and reserve. But after learning about concepts such as palliative care and patient-physician relationships, it seems unjust to gloss over one of the most vital roles of a physician — the ability to comfort patients in their most troubling times. ...continue reading →
Zeenat Junaid is a medical student in the Class of 2020 at Bahria University in Pakistan
“How do you make leukemia visible?” .
A British photographer and educator, Spence was a transforming voice in the arts of the last century. Her documentary-style photo albums dealt with themes of class struggle, conformity, and feminism. In 1982, she was diagnosed with breast cancer. A few years later, leukemia also set in. This cancer was not just in her blood and bones — it had seeped into her existence. It hijacked her arteries of security; it exiled her into grey plains of isolation she had never known before. Her whole career, she had sought to catch that special look — that nuance in a scene that told another story. But could she capture this tyrant phantom of disease now in her photos? How to express something for which words falter? ...continue reading →
Tyler Murray is an Internal Medicine Resident (R1) at the University of British Columbia who graduated from medical school at the University of Toronto in 2017
Fortunately, I found myself starting medical school unacquainted with death. I had only been to a single funeral, all four of my grandparents were still alive, and my entire extended family was relatively free from chronic disease.
Our first exposure to death in medical school was in the anatomy lab. At the end of the first week, we were brought down to the morgue and introduced to our cadavers. A small card with a simple line about who they were hung at the foot of the table: "54y male. Cause of death: lymphoma.” Over the next two months, we became intimately familiar with these bodies. Each day, we crossed a new boundary in a process of uncomfortable, progressive desensitization. I wonder now if this was intentional. ...continue reading →
Noren Khamis is a medical student in the Class of 2018 at the University of British Columbia
Long before starting medical school, I wondered how I would react to the first sight of a cadaver in the gross anatomy laboratory. I was comforted by the fact that when the time came, I would have sufficient warning, guidance, and—of course—preparation. But as often happens in life, situations do not go according to plan. Above and beyond mastering basic anatomy knowledge, those long days down in the cadaver lab taught me that I was truly unprepared to deal so intimately with death. ...continue reading →
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 →
Trevor Hancock is a professor and senior scholar at the University of Victoria’s
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 →
is 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 →
, 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 (IOM), a non-profit institution which provides objective analysis and recommendations to address problems related to medical care in the United States, issued the 2014 report . The IOM report proposed changes to U.S. policy and payment systems to increase access to palliative care services, improve quality of care, and improve patient and family satisfaction with care at the end of life.
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, . ...continue reading →