Palliative Care Grand Rounds

I'm very excited to be hosting the June 2010 installment of Palliative Care Grand Rounds, a monthly roundup of the most interesting palliative care and hospice blogs. (I've used a little creative discretion in defining palliative care and hospice blogs).

If you're not familiar with Bedside Manner, it's a two-and-a-half year old blog that focuses on compassionate health care. I write about special patient-caregiver relationships; programs that try to inject more humanity into medicine; interesting and relevant studies and much more. As you can imagine, issues of end-of-life and palliative care often figure into the conversation.

It was great discovering some new blogs and catching up on old favorites. I started out thinking I would stick to a theme or two this month, then quickly discarded that idea and simply collected posts that caught my fancy for any number of reasons. The topics are:

Reflections on Patient-Caregiver Relationships
21st Century Connecting
The Art of Listening
Making Art from Illness and Grief

Reflections on Patient-Caregiver Relationships:

Danielle Ofri, MD writes a beautiful piece in the New York Times about a patient of hers who died with few, if any human connections. The essay is her way of honoring the memory of a man who is buried in a "potter's field on Hart Island, a tiny sliver of land in Long Island Sound where unclaimed New Yorkers have been interred since the Civil War."

On GeriPal, Brad Stuart offers a moving definition of love - being willing to suffer along with a patient in pain - examining the difficult questions together, like when is it time to say "no" to further treatment.

Buddhist physician Alex Lickerman, MD lays out the Caregiver's Manifesto, a list of seven ways to make caring for loved ones who are chronically ill a better experience for everyone. Much of the advice is also relevant to people who aren't caregivers.

21st Century Connecting:

The Hospice and Caregiving Blog gives readers a primer on the different ways that Facebook can help with the grieving process.

On the heels of the flap about Facebook's confusing new privacy settings, I was intrigued by an item on Patients Like Me about a recent violation of the company's user agreement. The "user" was actually a computer program that was extractng data from a mood conditions forum. Company President Ben Heywood writes about the balance between openness and privacy in online patient communities. By the way, Ben is the brother of Stephen Heywood, a young man who died of ALS in 2006 and was the subject of a terrific documentary So Much So Fast.

Using a slightly older media - yearbooks - Hospice and Caregiving Blog links to a story from the Kansas City Star about how high schools do or don't memorialize students who have died during the year.

The Art of Listening:

On Better Health, Alan Dappen, MD saves a patent's life through the simple, yet powerful act of listening.

Beth Israel Deaconess Medical Center CEO Paul Levy, on his popular blog Running a Hospital, shares how compassion comes in many forms, including designing systems that minimize discomfort for cancer patients undergoing CAT scans, The idea of the new system came from listening to the feedback of a patient.

Making Art from Illness and Grief

Paradoxically, reading Debra Ruder's Goodbyes, a blog about death, is often very life-affirming. In the most recent post, she writes about a teenager's last visit with her grandmother at a nursing home in Greece and shares the poem the teen wrote about her beloved Yia Yia.

Zoe Fitzgerald Carter, author of a recent memoir about her late mother's wish to engineer her own suicide, writes a mother's day essay about her unsentimental mother's change of heart about a tender gesture - sending flowers. Check out her book Imperfect Endings - a fascinating journey down a difficult road with a thoughtful and amusing guide.

NY Times editor and writer Dana Jennings, who has been blogging about his prostate cancer for the past year, writes a terrific post about his new post-cancer hair style and its powerful symbolism.

At Pallimed Arts and Humanities, listen to actress-singer Charlotte Gainsbourg's sone about an MRI (the song's title is the procedure's' French acronym IRM), based on her experience with the machine after a skiing accident. Can you hear the machine in the background?

And for the finale, here a couple I couldn't shoe-horn into any category:

On Pallimed, Lyle Fettig writes about a study in Melbourne, Australia investigating the impact of advance care planning intervention on end-of-life-care in older patients. Of the 29 patients who died in the intervention group, 25 patients had their end-of-life wishes followed. That compares to the 8 out of 27 in the control group.

Finally in the "Shout out to Nancy Reagan" category, Mayo Clinic obstetrician and medical editor-in-chief Roger W. Harms, MD writes about how sometimes the most courageous things a patient can do is just say no (to medical tests with dubious utility.)

GeriPal.org is the host for the July edition of PCGR. Check them out for submission instructions.

PCGR now has subscription options; you can follow by email or RSS feed. An aggregated feed of credible, rotating health and medicine blog carnivals is also available.