When death knocks at your door is the palliative doctor in?

Like Caronte in Dante’s Divina Commedia shipped the sinful souls from one side to the other of the river Acheronte in the Inferno, palliative doctors deliever the “D” word to their patients.

They just do it with some extra care.

Palliative care to alleviate terminal hilliness patients’ symptoms with alternative methods to prolonging the patient’s life when they can no longer undergo surgery or ha no other option, but wait for the hands of death to take them with them.

The Journal of Palliative Medicine reports that the number of hospitals with palliative care programs in the United States has nearly doubled since 2000. Nearly 53 percent of hospitals offer 50 beds for patients undergoing palliative cure, according to the Report published in 2008.  Yet, some states, like California are lacking doctors with palliative training or states like New York  that require so much cash to implement palliative care.

This is genius and I wonder if under the Obama’s new health insurance plan there might be an increase in the number of palliative care facilities and if this happened if this could possibly lowering the costs of it all so that every terminally hill patient could get some caring doctor to cuddle him/her until death do them apart. Or is this only going to be a privilege of few?

In any case, I think palliative care is simply GENIUS. I am not being sarcastic. I am nothing, but serious. I have never once before heard medical students can actually enroll in classes to learn how to break “the bad news”to their patients to prologue and enhance their final days until I opened the New York Times on my way to the airport this morning and found a three-page feature story about the “art of plaintive medicine” and how this can help the patients cope with their hilliness during their last days on Earth when their chances of having surgery are very slim.

During most of my youth days, I have heard lots of talking about what would be the best method to deliver the “ugly truth” to a patient close to death and how could one better his last few days of life using the right combination of medicine and since my parents were doctors. The majority of our dinner conversations would lean toward surgical procedures or interesting diagnosis. Death was not really part of the conversation, but as young, curious girls, my sisters and I, would often ask my dad, a surgical oncologist, to tell us stories about the OR and what went on beyond the closed doors of the surgical room.

One day, to our dismal, I asked my dad how he usually approached beaking the ice with the family of the dying patient.

His answer has been engraved in my mind ever since then.

“I tell them the truth with tact,” he said. “I tell them we are at war, a big war, made of many battles that must be won one at the time for the war to be over. I tell them, we will fight each battle with all of our artillery and move to the next one with the same steadfastness and see if the enemy will surrender. Of course I give them a time estimate of how many days they still have to live, but I am not God, so I do not know how accurate that is.”

Now, imagine how many other times did my dad have to fail delivering a bad news to one of his patients before he got the right combination of compassion, truth, reason and tact?

Many.

And he only learned by practicing on real people with real diseases who sometimes faced death. There were no palliative care classes at his time in Med School.

Now, imagine if with the new universal health insurance you could train doctors to entirely dedicate themselves to get you over the “you-better-get-ready-because-you-are-gonna-die hump in case you are a terminally hill patient?” Wouldn’t that make the last days of those patients much more livable? And wouldn’t that also make the whole medical system less extraneous and scary?

I think so.

Now, of course this would cost extra money and probably many more ulcers among the, already-skeptical Republicans, but in the long-run, after the universal health insurance would be settled in, palliative care should definitely be implemented for its real worth:  A little more comfort before you die when nothing else worked.

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