Wednesday, March 4, 2009

Palliative Care Grand Rounds: Vol. 1, Issue 2

Presenting PCGRrrr!

There are so many wonderful writers with thoughts to share and tales to tell that are relevant to the fields of hospice and palliative care. Here are some of my favorites for this month's PCGR. I hope that you'll visit these talented bloggers often. (Oh, and little Olive will be helping out a bit here, too!)

Drew Rosielle MD, of Pallimed, gives us an emotional full plate with his post Not Safe For Work. Here, he's found a great podcast by Mike Destafano who does a wonderful job telling the story about events leading up to the death of his girlfriend from AIDS. Drew also includes a video from The Onion entitled,
"Courageous Man Refuses to Believe He Has Cancer". It's very funny and also gives you that weird little feeling of unease. You know, like 'I don't think I should be looking at this, but I must' kind of thing.

I pretty much use Twitter to let readers know that I haven't died between posts, but Christian Sinclair MD, of Pallimed, has really put it to good use. I had no idea it could be so versatile! If you want to know how Twitter can help you and how to get started, Christian's post, Twitter For Hospice & Palliative Medicine, is a must read!

Paul Levy of Running A Hospital is also a "Twitterer". His post, Twitter Etiquette, also discusses aspects of this micro-blogging service and his mysterious, new-found popularity.

I think I just 'twittered' in the hallway.

An excerpt from Hours-to-days, a poem by Risa Denenberg of Risa's Pieces:

"They need knowledge of a kind
not previously imagined. They want
to know when. And how to wait. What to say.
Things the doctor forgot to explain."

In another post by Risa, Unfinished Business, a story is told that brings to life a term commonly used and heard in hospice and palliative care.

ONCRN returns to work after having her baby. She commemorates this event with her wonderful, so busy, yet so tired, poem back.

Amber Wollesen MD, of Pallimed: Arts & Humanities, takes a moment from her hectic day to ponder a family's "thank you" card, herself and Robert Frost in Stopping to Appreciate the Roses with Robert Frost.

Jessica Knapp of The Good Death contemplates how readily we use death metaphors in Death as a Metaphor for a Cluttered Life. Jessica also gives us a laugh with That's What a Hospital Is For.

Speaking of which... shrimplate knows what a hospital is for. The nurses (duh!). Read this nurses's take on the matter in Songs About Buildings But Not Food. Another great story from shrimplate is How Doctors Decide Whether a Patient is Sedated From Opiate Overmedication or Just Plain Dying.

Gail Rae Hudson of The Mom & Me Journals dot Net wants to explore the dying process from the "dyees" point-of-view. Much easier said than done. In her post Finally! My Kind of Snow, Gail skillfully tells of her search for answers and performs an in-depth comparison of information gleaned from The Tibetan Book of Living and Dying with her own mother's recent death.

Never one to pull punches, Leo Levy at DNR/DNI gives us a two-part story that is a "DNI" conundrum and then some. For a great read, check out Nursing on the High Wire (Part One) and Part Two. Leo also teaches us the value of putting forth a little extra effort in patient communication with Quadriplegic For Life.

Another great lesson in the value of good communication comes from Bruce Campbell MD in his post The Pre-op Visit. Read and see how "jumping to the end" can alleviate so much anxiety for the patient.

Marachne, a hospice/palliative nurse and doctoral student, takes us into her classroom as she and her students discuss a case study... but it's so much more than that. Please read this wonderful post, Expectations and Filters.

Hospice Guy gives good advice and some surprising insight into Continuous Care Issues. He really opened my eyes to this seldom discussed aspect of hospice care.

David Tribble MD, of Alive Hospice Blog touches on a phenomenon that's rather near and dear to me. His post, Visits From the Dearly Departed: Hallucinations or Sacred Encounters?, treats this subject with the respect that it deserves.

Pressure ulcers are unfortunately, an all too common problem among the dying. Angela Morrow RN, at, stresses the importance of pressure ulcer prevention and knowing the risk factors. Her post, Dying with a Pressure Ulcer, serves as an important resource for all caregivers.

Fresh Widow gives us a chuckle with her "inventiveness" in her post Introducing My New (FREE) Product! The Widow Card!. Also... a memory of missing pain meds for her dying husband inspires this post, Two and a Half Years, Dozens of Anniversaries.

I find myself at a loss for words when trying to describe this blog... In October 2007, this family physician's then three-year-old son was diagnosed with a cancerous brain tumor. On February 26th of this year, little Henry died. Please spend time with Dr. Smak.

Thaddeus Mason Pope of Medical Futility has a great post, The Pope Confuses Me - The "New Eugenics".
In this article, Mr. Pope cleverly reveals an inconsistency in the Pope's (no relation, I presume) logic regarding the mind and body.

Along the same line of thought, Maurice Bernstein MD of Bioethics Discussion Blog, reviews the sad case of Eluana Englaro. This Italian case brings back many memories of our own Terry Schiavo. Dr. Bernstein's Suffering, the Unconscious and the Application of Dignity: What is the Science, What are the Ethics? boldly examines this frustrating conflict.

Let us not forget those who died in the bushfires in Victoria, Australia. Hospice and Caregiving Blog pays homage to the victims and discusses the effects of public tragedy in Mourning a Public Tragedy in Australia.

Let us also not forget all the wildlife that lost their lives in this horrible fire... Peter McCartney RN of NSW, Australia gives us this "moment of awwww" in his post Sam the Koala. As Peter so nicely states, "These clips may not seem earth shattering but for us Australians Sam shines as a representative of the millions of animals, birdlife and reptiles lost in these fires..."

Many thanks to all our readers and contributors! Next month's PCGR will be held Wednesday, April 1st at The Good Death.

Bookmark this page so you can come back
and chew on it some more!

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Christian Sinclair said...
This comment has been removed by the author.
Christian Sinclair said...

Awesome job Dethamma! You really covered a whole lot here. The photos and caption are a very funny touch.

"I just 'twittered' in the hallway." - That almost made me twitter my self.

Everyone help spread the word about PCGR!

Risa Denenberg said...

Thanks for a job well done. Lots of new blogs here to visit. Great work! It's looking like, well, a community.

Christian Sinclair said...

I deleted my duplicate comment.

Also don't forget to read the interview with Dethmama where we learn the origins of her blogging name.

And you can subscribe to the RSS feed also so you never miss a edition of PCGR. (Published monthly)

Gail Rae said...

Wonderful edition, so varied and interesting! I actually read every single post, including my own, and commented on quite a few.
Your hard work, and maybe even your fear of having little to post, paid off in spades! I also agree with risaden, I love being introduced to new blogs, and, she's right, I'm also picking up a real sense of community!
You did better than good, dethmama! You honored and expanded a new and promising community!

dethmama said...

@christian, risa and gail... Thanks so much for your kind words and great submissions.

Peter said...

Hi! I have to admit that at times I think I could have been dealt better cards in life, but having gone through your list and the stories behind them, I have very little to complain about.

Thank you for sharing them and highlighting the terrible destruction in Victoria, Australia.

Take Care,

Keith "Nurse Keith" Carlson, RN, BSN, NC-BC said...

So happy to have been found by you on Twitter, and now to have discovered your blog.

All the best, and a great Palliative Grand Rounds!


Jessica Knapp said...

Oh, this is so great. I knew it would be ... but I love it! And cute little Olive just makes it :)

Supa Dupa Fresh said...

Thanks for the link, and I'm enjoying reading your blog. I too want to write something about that story in the Onion... esp. because the wife even LOOKS like me.

But someday I will write up my hospice horror stories. You seem great, but I had some bad times when Gavin was dying.

dethmama said...

@ supa dupa fresh... I'm sorry that your hospice experience was so negative. I hope that you took your issues to hospice management and that they took them seriously.

Christian Sinclair said...

Supa Dupa Fresh,

First of all great Missy Elliot reference in your moniker.

Hospice is so many things for many people, but it is important to remember that it can fail to provide the needed support. Hospice services often get such glowing report it is easy to forget or gloss over times when things did not go well. Only through good structured critique and feedback do we have the opportunity to improve.

I look forward to hearing your stories.

Supa Dupa Fresh said...

Dr. S and Mama,

Okay, I've recorded it. Yes, I should have taken it to the top but was not inclined to be a good customer. As so few of us are. Perhaps now I could do that?

Anyway, FWIW here are my experiences: