Dawn to the Moon

Today began at the break of dawn and ended with the moon outside my window. I can hardly believe I am saying this – I miss the coronary care unit. The emergency department is a flurry. Placing too much emphasis on patient flow does not always mean providing the best care. I miss talking to my patients, listening to their stories, caring for them, and answering their questions. I can hardly estimate the number of patients whom I cared for today or remember them – 5 or 6 were flooding through the doors every hour.

A wonderful article was published today in The New York Times yesterday, Palliative Care Extends Life of Lung Cancer Patients, Study Finds. A study in the New England Journal of Medicine has demonstrated that patients with terminal lung cancer were happier, more mobile, in less pain – and they lived nearly three months longer. This study supports some of the thoughts I discussed from Gawande’s recent article in a previous post, The End of Life: Hope Without┬áCure. It offers proof that the purpose of palliative care is more than simply “to palliate” – it can also improve quality of life and can even extend life. Palliative care, along with alternative medical therapies including acupuncture and massage, can be important adjuncts to medical care. This needs to be further examined in the science-based health care system of the western world. More on this later.

For now, as the clouds begin to obscure the moonlight, I breathe – long and deep – to expel the chaos of the day. Working in the emergency department is draining in a different kind of way – fast-paced, high energy, elevated stress levels. It is not as much a marathon but a series of very long sprints.

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