Tag Archives: palliative care

The Universal Experience that Medicine Hates Talking About Most

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[Content warning: this episode contains frank discussions of death and dying that some listeners may want to skip.]

Doctors need to actually ask patients what a good death looks like to them

Medical students learn so much anatomy and pathophysiology, the social determinants of health, and the practice of medicine. Meanwhile managing death—one of two things every single patient experiences—gets squeezed into a few short lectures. It can sometimes feel like hospice and palliative care are afterthoughts.

Of course, med students train to be healers, to fix what is broken. But a conversation about the end of life, and the patients’ goals for that most solemn event, is so important that it’d be nice if physicians and physician assistants could do that without sweating through their scrubs.

That 89-year-old patient joking about being “ready to kick the bucket” needs a provider who can stop and talk when they’re asked what dying actually looks like. The family demanding “everything be done” deserves someone who stops to explain what “everything” really means. And the chef who refuses the feeding tube isn’t being stubborn—he’s making the most rational decision about quality of life you’ll hear all week.

PA2 Chloe Kepros, M2s Sarah Nichols and Nick Lembezeder, and M1 Jonah Albrecht discuss the economics driving end-of-life care costs, explore why palliative care should start at diagnosis instead of six months before death, and examine how their medical training creates providers who can make speedy life-and-death decisions for their patients, but don’t have time to process watching them die.

Episode credits:

  • Producer: Chloe Kepros
  • Co-hosts: Jonah Albrecht, Sarah Nichols, Nick Lembezeder

The views and opinions expressed on this podcast belong solely to the individuals who share them. They do not represent the positions of the University of Iowa, the Carver College of Medicine, or the State of Iowa. All discussions are intended for entertainment purposes only and should not be taken as professional, legal, financial, or medical advice. Nothing said on this podcast should be used to diagnose, treat, or prevent any medical condition. Always seek qualified professional guidance for personal decisions.

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Continue reading The Universal Experience that Medicine Hates Talking About Most

The Ethics of End-of-Life Care (Recess Rehash)

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[We’ll be back next week with a new episode! For now, take a listen to this re-run!]

Decisions made at the end of life are among the most complicated.

  • M1 Jeff, M3 Ananya, and MD/PhD students Riley and Miranda discuss what they’re taught about the ethics surrounding the end of life.
  • What are the physician’s responsibilities? How do they balance the patient’s wishes, the family’s desires, the directive to do no harm and to provide the best possible care, and the need to ensure that such considerations are supplied to any and all patients.
  • Add in the myriad cultural and religious beliefs that doctors, patients, and families have, and you get quite a difficult set of calculations to ponder.

We Want to Hear From You: YOUR VOICE MATTERS!

No matter where you fall on any spectrum, we want your thoughts on our show.  Do you agree or disagree with something we said today?  Did you hear something really helpful?  Are we delivering a podcast you want to keep listening to?  We’ll be sure your ideas are heard by all–leave a message at 347-SHORTCT (347-746-7828) and we’ll put your message in a future episode (use *67 to be an “Unknown caller”).

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Continue reading The Ethics of End-of-Life Care (Recess Rehash)

The Ethics of End-of-Life Care

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Decisions made at the end of life are among the most complicated.

  • M1 Jeff, M3 Ananya, and MD/PhD students Riley and Miranda discuss what they’re taught about the ethics surrounding the end of life.
  • What are the physician’s responsibilities? How do they balance the patient’s wishes, the family’s desires, the directive to do no harm and to provide the best possible care, and the need to ensure that such considerations are supplied to any and all patients.
  • Add in the myriad cultural and religious beliefs that doctors, patients, and families have, and you get quite a difficult set of calculations to ponder.

We Want to Hear From You: YOUR VOICE MATTERS!

No matter where you fall on any spectrum, we want your thoughts on our show.  Do you agree or disagree with something we said today?  Did you hear something really helpful?  Are we delivering a podcast you want to keep listening to?  We’ll be sure your ideas are heard by all–leave a message at 347-SHORTCT (347-746-7828) and we’ll put your message in a future episode (use *67 to be an “Unknown caller”).

We want to know more about you: Take the Listener Survey

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Bonus Episode! Palliative Care: A Perspective from A Land Where It Barely Exists, ft. Dr. MR Rajagopal

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Palliative care is not a thing in India, mostly.

In most of India, palliative care–a medical specialty focused on improving the quality of life of people with life-limiting or disabling diseases–is available to only 1% of people who need it.  But in Kerala, one organization is making lots of headway in promoting this vital specialty.  In this episode, Pallium India’s founder, chairman, and 2018 Nobel Peace Prize nominee Dr. MR Rajagopal visited the University of Iowa College of Medicine to talk about their efforts to introduce to Indian providers a new way of thinking about pain and other symptoms by providing emotional, social and spiritual support.

As you might expect from such a practitioner, Dr. Rajagopal is an extraordinarily thoughtful man with a kind, quiet voice that belies what must be an extraordinary force of will needed to accomplish his goals.  Tony Rosenberg, Ellie Ginn, Rachel Schenkel, and Jayden Bowen discussed how he began his journey, what his fellow Indian providers made of these ideas, and what his hopes are for the future of palliative medicine around the world.

We Want to Hear From You

Do you or anyone in your family have experience with palliative care? Tell us about it at 347-SHORTCT anytime, visit our Facebook group, or email theshortcoats@gmail.com.  We’d love to hear from you!

Continue reading Bonus Episode! Palliative Care: A Perspective from A Land Where It Barely Exists, ft. Dr. MR Rajagopal

The Examined Life Conference

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elcOur show this time was record in front of a remarkably appreciative audience at The Examined Life Conference, and it was a lot of fun.  We talked with several presenters from the conference, including Gabriel Ledger an emergency physician who became a filmmaker when he decided he wanted to find out more about the patients he’d encountered in the ER.  We spoke with Emily White, an Iowa undergrad who has been doing research on Dignity Therapy and who no doubt has a bright future in medicine.  Toni Becker is a speech language pathology grad student whose portraiture and interviews of people with disabilities remind us of their significance.  Susan Ball is associate director of the New York Presbyterian’s AIDS care center, and shared with us her experiences as a physician at the start of the AIDS epidemic.
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