My late husband, Bob, was a hospice and palliative medicine physician. Early in our relationship, as we shared family histories, I told him about my brother David. When David was 13 (I was 18), he was in an accident and remained in a coma for 21 days. For years I
If you are a healthcare professional and feel put upon, underappreciated, overlooked, and taken for granted by administration, it is entirely valid. Many administrators on both the provider and payer side of healthcare fail to recognize that without the talent, the show simply cannot go on. Unlike Broadway and Hollywood,
In palliative care, we have a front-row seat to love in action. We watch adult children pour themselves into caregiving for aging parents—managing appointments, medications, decisions, grief. But increasingly, those same caregivers are also raising children or supporting young adults at the very same time. They are “the sandwich
Every October, we do something bizarre. We cover our houses in skeletons, ghosts, and gravestones. We dress up as zombies. We tell creepy stories. We watch movies about death… for fun. And yet, bring up real death at the dinner table and suddenly everyone needs to “go check the laundry.
Trauma is not just an emotional experience—it is a physiological and neurological event that leaves lasting imprints on the brain. For palliative care providers, understanding these changes is vital. Patients in our care may carry a history of trauma, whether from childhood adversity, war, intimate partner violence, medical interventions,
In Buddhism, there is a powerful teaching story often referred to as “the bird on your shoulder.” A monk asks his students, “If a bird sat on your shoulder and whispered, ‘Today could be the day you die,’ how would you live?” The question is not meant to frighten—but
October is Down Syndrome Awareness Month—a time to celebrate the lives, stories, and strengths of individuals with Down syndrome and the families who love and support them. It's a moment to pause, learn, and reflect on what it truly means to be inclusive, to embrace diversity in
In hospice and palliative care, we often stand at the intersection of life’s most profound questions. Patients and families ask us what truly matters at the end of life and what makes life meaningful. Remarkably, one of the longest-running studies in the world gives us answers that echo what
Alzheimer’s disease disproportionately affects women. Nearly two-thirds of all patients living with Alzheimer’s are female, and while increased life expectancy explains part of this difference, it does not tell the full story. Emerging research suggests that biological factors—including differences in brain lipid metabolism—play a critical role
Introduction As palliative care providers, we often encounter patients whose decline seems sudden or inexplicable. A seemingly healthy older adult—with normal cholesterol, reasonable blood pressure, and an active lifestyle—may present with memory lapses, slowed thinking, or difficulties with daily tasks. When imaging reveals extensive white matter changes and
In palliative care, timely recognition of cognitive decline is essential for guiding treatment planning, supporting families, and aligning care with patient values. Recent research into the use of voice as a biomarker for dementia offers an exciting frontier: the ability to detect subtle cognitive changes years—sometimes a decade—before
It was 9:12 a.m. on a Friday when my cellphone rang. On the line was a primary care colleague—one of those overbooked, overworked, and too often undervalued physicians who quietly form the backbone of our healthcare system. For them to call me directly during a packed clinic