After 3 decades in primary care medicine, I should be feeling a level of comfort with dealing with people, mostly seniors, in the declining phases of their lives. With this kind of experience, there is a certain comfort that you have gleaned what is useful from your training, you have seen most things, and solved, as best as one can, most health problems, whether with a newer medicine, the right specialist, a better strategy to avoid toxic influences, or perhaps a better diet or exercise plan. Regrettably
In physician/author Atul Gawande’s provocative and insightful book, “Being Mortal” (2014), he states clearly that, while modern medicine has given us remarkable power and options to push back at most of the complex medical problems we face today, we physicians in medicine can do significant damage “…when we fail to acknowledge that such power is finite and always will be.” (p.259). While people are indeed living longer and better than in any time in history, we are medicalizing aging and dying, to the poin
Both families with aging relatives, and the doctors taking care of them need to have some tough conversations that both are preferring to avoid. It is hard enough to face the facts of a life in its final stages, and more difficult to navigate the possibilities and availabilities of current treatments. But it is hardest for both parties to speak in terms of what is most important to them at this stage of their lives–reflective of a need to shift from a quantitative need to maximize length of life, to a qua