Finding the Right Words at the Right Time — High-Value Advance Care Planning  

Oleh:

Sanders, Justin

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: The New England Journal of Medicine (keterangan: ada di Proquest) vol. 372 no. 07 (Feb. 2015), page 598-599.

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Perpustakaan FK Nomor Panggil: N08.K Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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When Ms. C. died, I was sad but not surprised. I had met her 4 years earlier, when I was an intern and she was the first patient who identified me as “my doctor.” She did so enthusiastically, asking the inpatient medical teams who frequently cared for her to run every decision by me. As a trainee, and given her complex needs, I found those requests both absurd and overwhelming. By 65 years of age, Ms. C., a lifelong smoker, had coronary artery disease, atrial fibrillation, diabetes, and chronic obstructive pulmonary disease (COPD) complicated by pulmonary hypertension. During the time I knew her, she was hospitalized at least every 3 months for complications of one or another of her chronic conditions. The only thing she hated more than the hospital was the panic induced by uncontrolled dyspnea, chest pain, or palpitations — the panic that led her to dial 911. When she came into the clinic for follow-up, she'd tell me that she never wanted to go back. I would check to make sure she understood her medication changes. She would ask about my family. I would plead with her to quit smoking. A gregarious Latina, she always shouted “I love you” as I walked out of the room.

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