Wednesday, August 04, 2010

Palliative Care Grand Rounds 2.8

Thanks for visiting me on this most auspicious PCGR day. Since I moved to a new state and started a new job a couple of months ago, I didn't have time to come up with a fun hosting concept the way I did in September. Nonetheless, I hope you'll enjoy these heartwarming, thought-provoking, and ever interesting posts. These blogs will most likely be new to you, with a few staples thrown in. Be sure to comment on the ones you like or have a response to. We bloggers love feedback!

Hold My Hand follows the life and times of a nursing home social worker. I appreciate that HMH shares the story and reflects on her own actions and reactions. She writes a moving account in The Language of Love about a care conference with a resident and the resident's daughter. Don't be surprised if you find yourself looking for kleenex by the end.

I'm fascinated by OrthoOnc's use of technology! First, he test-drives the iPad in the operating room. Then how the iPhone's FaceTime could be used for telemedicine.

A primary care physician is the brains behind Musings of a Distractible Mind. Dr. Rob's posts are sometimes funny, sometimes serious, and always worth reading. A Letter to Patients with Chronic Disease explores how to improve the patient/doctor relationship and has generated follow-up posts and lots of comments. If that's not enough to make you a subscriber, then read Failure, an examination of whether a patient's death or suffering equals a doctor's failure.

Pallimed, as always, has a wealth of possible PCGR contributions. New Pallimed contributor Holly Yang discusses findings in the Quality of Death report, which ranks end-of-life care from 40 countries. She also wisely links to one of my favorite Pallimed posts from July: the Life Before Death website.

You can't talk about Pallimed without mentioning Pallimed: Arts. A perfect blend of my interests! I was struck by this profile on musician Fred Hersch. Diagnosed with HIV at age 29, he was recently interviewed by NPR's All Things Considered. He notes, ""For at least the first number of albums I made on my own, I really had this kind of dramatic feeling like this is going to be my last statement and I just wanted to create enough of a body of work that if I died I might somehow be remembered." How's that for living as if you were dying?

One of my favorite recent finds is Dr. David's Blog, the musings of a pediatric oncologist. Absolute must-reads: an ethical dilemma ("Who gets to decide if the 5% chance of a cure is worth the risk? Is this chance of success so small as to qualify as futile?") and tackling the hardest question: "How much time do I have left?"

Taking the scenic drive's author is a PICU RN who plans to go to medical school. Read through her ethical dilemmas and ponder what you would advise.

Her profile says she's a family doctor, mother of 3, and relearning life without her son Henry, who died about a year and a half ago. Her posts about grief are raw and honest. Her posts about patients are insightful and compassionate.

An ER nurse writes about the difficulty in have palliative care conversations in the emergency room. This also leads to reflection on the loss of a friend and the conversations she had with his family.

A Memorial Sloan-Kettering Cancer Center intern reflects on this article: Americans are treated, and overtreated, to death. Conveying that hospice or palliative care is not "giving up hope" may be one of our biggest mountains to climb.

Sarah is not a palliative care or hospice blogger. Her mom died 3 years ago. She just found out the FDA revoked her mom's main chemo drug "for not helping patients." Her response, her pain, her anger is not for the faint-hearted. This is the aftermath of grief.

GeriPal draws attention to the Atul Gawande article Letting Go: What should medicine do when it can't save your life? and then offers this response. Take the time to read Gawande's article first. Also of note, Why not palliative oncology?

[Ed. note: A Pastor's Cancer Diary also offers worthy commentary on the aforementioned Atul Gawande article.]

As I've compiled the posts for PCGR this month, it seems an unintentional theme has emerged. We need more conversation. More conversation about treatment options and when it's time to consider palliative care and hospice. More conversation about our wishes during treatment and at the end of life. More conversation about how loss affects us. I can only hope that PCGR enables us all to take time for these conversations, which inevitably will help us do our jobs better. I know this community has helped me. May it also be a blessing to you.

PCGR has subscription options; you can follow by email or RSS feed. An aggregated feed of credible, rotating health and medicine blog carnivals is also available.


Marty Tousley, CNS-BC, FT, DCC said...

You've given us a treasure trove of information! Thank you so much for pointing us to so many wonderful resources, several of which I've not known about until now. I will be reading for a month!!

Dr. Rob said...

Thanks a lot for the promotion. I am greatly thankful for the palliative care teams I get to work with. Any doc who cares for his/her patients feels strongly about palliative care.

risaden said...

Great round of posts here, great job at hosting. Thanks!

D. Addiction said...

Very useful blog gives the information of the confessions of a Young social worker. This will helps u a lot.

Katherine Krause said...

The familiar and comforting mix of the sounds of crickets, rainfall, music, other soft soundscapes on Bernie Krause's 'Nature' album can be soothing to clients, family members, and caregivers alike. We'd like more Palliative and Hospice Care providers to know of this wonderful resource, especially the album, "Nature":

Hold my hand: a social worker's blog said...

Oh my goodness! Thanks for mentioning by blog! That was very thoughtful of you.