California Health Information | Health AdviceNavigation
Be Well, Be Well Informed
“When should we try to fix and when should we not?” asks Atul Gawande, M.D., MPH, in his latest bestselling book, Being Mortal: Medicine and What Matters in the End. Dr. Gawande is a practicing surgeon at Brigham and Women’s Hospital in Boston, a professor at Harvard Medical School and the Harvard School of Public Health, a staff writer for The New Yorker and executive director of Ariadne Labs, a global health care innovation center.
Being Mortal is his fourth bestselling book. It’s a physician’s personal journey toward a better understanding of aging, serious illness and what it means to balance prolonging life with preserving the treasured priorities that mean the most to each human being as that life draws to a close.
Dr. Gawande is also the featured speaker at Mills-Peninsula’s Community Health Dinner and Lecture and the annual Mills-Peninsula Luncheon and Lecture in April 2016, benefiting the Mills-Peninsula Palliative Care Program and breast health programs.
In anticipation of his April visit to speak at our Mills-Peninsula events, we asked Dr. Gawande to share his insights about how doctors, patients and family members can partner together to help loved ones live a life that is meaningful to them all the way to the end of life.
Q: What were the key takeaways you learned from researching and writing Being Mortal?
DR. GAWANDE: I ended up interviewing more than 200 patients and family members about their experiences with serious illness and infirmity. I also interviewed scores of clinicians including palliative care physicians, hospice teams, nursing home aides and directors. The people who were really great at what they were doing had learned several key things. Read More about A Conversation With Atul Gawande, MD: Living a Good Life All the Way to the End
Atrial fibrillation (AFib) is a heart rhythm disorder in which the steady electrical impulses that regulate the atria, the heart’s upper chambers, become disorganized and chaotic. These abnormal signals cause the atria to contract rapidly and ineffectually, over and over. This reduces the flow of blood to the body, causing shortness of breath, weakness and fatigue. It also increases the risk of heart failure and stroke.
Palliative care is a medical specialty that helps people who are facing a serious health crisis, whether chronic or terminal, at any stage. The word palliative comes from the Latin verb “palliare,” which means to put a cloak around someone — a simple gesture offering physical comfort and support.
“In the purest sense, the concept of palliative care is to be present, attentive and emotionally supportive, physically providing comfort and accepting a person for who and where they are,” says Suzanne Pertsch, M.D., medical director of Palliative Care at Mills-Peninsula. Read More about What Is Palliative Care?
It is said that an apple a day keeps the doctor away. But for disease prevention and to achieve optimal health, you may want to eat the apple and cultivate a close relationship with your doctor. “As doctors we can advise people on health issues, but achieving a good outcome is a partnership,” Natalya Denissov, M.D., a Mills- Peninsula family medicine doctor, says. “To me, it is important to meet a patient where he or she is, build a relationship first and come to an agreement on a goal or treatment. Then the person needs to take an active role in the treatment and maintenance.” Read More about The Disease Prevention To-Do List
Too often, doctors and families are unable to honor patients’ or loved ones’ wishes for care during a serious illness because the patient has not made his or her health care wishes known in advance. Within Mills-Peninsula’s support and coaching program for older adults leaving the hospital, called Peninsula Circle of Care, nurses see this situation frequently.
“Many people that we work with have thought about their wishes,” Yvonne Chan, R.N., MSN, GCNS-BC, program manager for the Peninsula Circle of Care, says. “But few of them put that information into an advance health care directive document that can be referenced in case a medical situation arises if they are unable to speak for themselves.” Read More about Advance Health Care Directives Help Make Your Wishes Known
For people with an addiction, the holidays may pose a particularly challenging set of circumstances that can make their situation worse. These include:
Loneliness: Social isolation can be deeply felt during holidays that emphasize relationships and family.
Family stress: As families come together for the holidays, conflicts between family members can become more intense.
Relaxing of social constraints: Holiday parties and the general celebratory mood loosen normal social codes about how to behave. Overindulgence, whether in food or alcohol, is more common.
Financial stress: The holidays can be very expensive, and someone worried about how they will afford all of the gift and parties of the season may turn to substances to lessen the stress.
When someone you care about is suffering from addiction, it can be emotionally wrenching because the addicted person will often blame his or her problem on the nearest people and situations, Philip Kolski, a licensed clinical social worker at the Mills-Peninsula Behavioral Health Center, says. This, of course, pushes the people who are trying to help away.
“The addict is not in control any longer,” he says. “The person’s sole focus is to relieve the pain inside. As a result, addiction is a very lonely disease because often the addict has no support system left.” Read More about A Team Approach to Tackling Addiction