Feeling the void

Many years ago, a wise family practice mentor said to me “One of the nice things about being a physician for many years is that my patients have grown old with me. Unfortunately that means I am losing more of them.” Those words came back to me recently after the loss of my third male patient in six months, all close to my age. Two of them, avoidable deaths but work and inflammation came before healthy habits and lifestyle changes. The third was from a quick and devastating disease that was not avoidable.

The wife of the third man came in for a visit yesterday. We talked a little bit about his disease and its quick progression. She talked about the usual things–their 30 year marriage, children, hopes for grandkids. I told her that I would miss him after our many year patient-doctor relationship. I hesitated, then shared with her that it had been a rough year with patient losses and that he was one of three men that died much too young–at 70 he had been the oldest. She looked at me and said “then you feel the void.”

Obviously, not the same way that she does, but indeed, I feel the void.

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Engage with Grace

Every year at Thanksgiving, Engage with Grace asks bloggers to participate in a yearly “blog rally”, a term I’d never heard of before. Bloggers encourage their readers to spend a little time discussing end-of-life (EOL) values with their families while giving thanks. An excellent tool for this is the One Slide Project, which is found on the Engage with Grace website. The site gives suggestions on how to introduce the subject and facts on why it is so important.theoneslide

On more than one occasion, I have watched families struggle to determine the best course for a loved one who could no longer decide for herself. Sometimes, family members from out of town are unwilling to give up their loved one and futile care goes on much longer than anyone anticipates, leaving a swath of guilty and angry family members and damaged relationships that can last for years.

On Tuesday night, the #HCLDR twitterchat centered around end-of-life issues. We had been thoroughly primed by Lisa Fields’ thoughtful blog post (@PracticalWisdom) and the thoughts flew fast and furiously. For a transcript, please click here. Above all, there was agreement that EOL discussions are important and if your primary care physician is not asking you what your wishes are, you should be telling him. Don’t wait until it’s too late and people that you don’t know or don’t want are making decisions for you. Make this holiday of thanks an opportunity for your family to understand your wishes. And you theirs.


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