By Atul Gawande, New Yorker Magazine
People have concerns besides simply prolonging their lives. Surveys of patients with terminal illness find that their top priorities include, in addition to avoiding suffering, being with family, having the touch of others, being mentally aware, and not becoming a burden to others. Our system of technological medical care has utterly failed to meet these needs, and the cost of this failure is measured in far more than dollars. The hard question we face, then, is not how we can afford this system’s expense. It is how we can build a health-care system that will actually help dying patients achieve what’s most important to them at the end of their lives.
Read more here.
For most of human history, death was a common, ever-present possibility. It didn't matter whether you were five or fifty - every day was a roll of the dice. But now, as medical advances push the boundaries of survival further each year, we have become increasingly detached from the reality of being mortal. So here is a book about the modern experience of mortality - about what it's like to get old and die, how medicine has changed this and how it hasn't, where our ideas about death have gone wrong. With his trademark mix of perceptiveness and sensitivity, Atul Gawande outlines a story that crosses the globe, as he examines his experiences as a surgeon and those of his patients and family, and learns to accept the limits of what he can do. Never before has aging been such an important topic. The systems that we have put in place to manage our mortality are manifestly failing; but, as Gawande reveals, it doesn't have to be this way. The ultimate goal, after all, is not a good death, but a good life - all the way to the very end.
Research shows that palliative care given alongside oncological treatments not only improve patient’s quality of life with them having less depression, anxiety and other negative symptoms, they also live two months longer. This was shown in a group of patients with advanced lung cancer who received usual oncology care or oncology care and palliative care:
An open letter by Dr Margie Venter
I suppose it happens to everyone. That question that starts the conversation – ‘so what do you do?’ But unfortunately, oncology is quite a gloomy conversation starter.
Although it gets everyone talking, I get bored when it evolves into an epidemiological discussion like: “What do you think – is the incidence on the rise?” What I am curious about, however, is the experience of oncology within the realm of palliative care in a non-curative setting.
We don’t seem to have a very encouraging reputation in this regard, which in some ways I think is unfair. Often, it’s the ones left behind who are telling the story and are biased because they are grieving. Survivors would tell a different story, but then again, that really is a different story. The last days of living with cancer will hopefully be a tale of the impact of the cancer and not its treatment. Sometimes lay people get that mixed up; to them it is all one blurry reality, almost like a nightmare. Still, it does warrant some reflection.