It’s easy to assume that all medicine is interchangeable; that if you’ve worked your way up the chain of command, from intern, to resident, to fellow in a specialty, especially in the tentacled realm of internal medicine, that you would assuredly be good to go with knowing enough about everything. Some of the more prestigious specialties, like cardiology or pulmonary/critical care, assume their knowledge supersedes. And with taking care of critically ill patients, there is a

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Death determines everything. We may pay such a comment modest lip service, articulating things like ‘Carpe Diem,’ but until we feel

I read about Tatiana Schlossberg today, that she had just passed. I read her words in The New Yorker also. It is so difficult to imagine what some people must go through in fighting to be well. The pain of realizing young that you are not meant to live long is unbearable, especially when it seems unfairly out of sync, in contrast to the expected timeline of life. She was only 35, with two little children, one of whom she never got to take care of intimately because she fell s

When I was a little girl, I would spend summers with my extended family in France. There was a beautiful rhythm to life then, centered around meals. I recall evening-time, when we would all be assembled for dinner, on the terrace with the swallows swooping in large loops near the mountain near us. I recall how we would eat well, and what I recall the most, were the vigorous discussions and debates which would often take place. So, in hearing about Charlie Kirk's death, I was

One of the key features of end of life care is knowing what is reversible and what is irreversible. And adjunctively, it is essential to...

There's a little secret most people don't know. This secret is: on the whole, hospitals don't manage mortality well - especially those...

I recently had a very tough case; not necessarily because the medical case in and of itself was difficult, but because the patient...

I started this blog because I knew that everything in the world came back to palliation. That is to say, everything in the world comes...

Life is all about palliation. And palliation is about learning to accept. Learning to accept doesn't mean losing hope, or stopping...

It’s not always easy to know if you’re doing the right thing. When you’re medicating at the end of life, you hope that what you are...

There's a myth in medicine, somewhat of a noble lie perpetrated by the industry so to speak, which has a profound impact. This myth is...

I am an optimist. I want my patients to have hope, I want to help them keep hope. And when I see a patient who has the potential to...

We can choose two routes, especially depending on the urgency of the diagnosis. We can choose to feel disempowered, or we can consider...

A (quiet) little note, I avidly write verse. It's actually one of the forms of writing I like best, free and open-heartedly expressive,...

Death is spiritual. I’m always in awe at how spiritual death is. It may appear clinical - we desperately want it to be so because we try...

When I’m asked what I do, and I answer that I’m a hospice physician, I often feel a sudden downward energetic shift, a palpable sense of...

When I worked at my prior hospice, we were cutting edge. We brought everything we could home. ALS, LVAD’s, decels, intractable-symptom...

Sometimes what we offer is not enough. We can offer all sorts of modalities to manage decline and we can do it well. But we cannot...

Healing and cure are two different entities. Cure, a medical term, doesn’t often come without cost. It is a medicinal or medical “fix...