This episode is the first of a 4-part series that introduces you to the members of a palliative care team. Today Dr. Colin Scibetta discusses his role as the physician on the team and how palliative care differs from hospice care. In future episodes you’ll hear from the team nurse, social worker and chaplain.
As this episode airs I am enjoying a trip through Spain, including cycling in the Andalucia region! I’ll be back home in a few weeks to report on the trip. Follow me on Instagram to see my photos at kwyattmd or this link: https://www.instagram.com/kwyattmd/
This interview will cover:
What palliative care consists of
The difference between palliative care and hospice
The benefits of palliative care for patients
How the whole-person approach of palliative medicine also benefits care providers
Why Providence Institute for Human Caring (et al) was awarded the Circle of Life Award from the American Hospital Association
Colin Scibetta MD is a fellowship-trained palliative medicine physician who complete his undergrad in neuroscience and biology at Wesleyan University. He then moved to Ecuador where he worked on a health initiative for indigenous communities impacted by oil development. Dr. Scibetta did his undergraduate medical training at the University of California, San Francisco School of Medicine, where he also completed an internal medicine residency and a fellowship in hospice and palliative medicine.
Remember to tune in next week for Part 2 of this palliative care series! If you enjoy this content be sure to share it with others who might find it helpful and consider leaving a review on iTunes.
Learn about the life of Cicely Saunders and what we can discover from her quest to change the way that people died.
In this episode, recorded just after the celebration of what would have been Cicely Saunder’s 100th birthday, I talk about how she became interested in caring for the dying, what inspired her to create St. Christopher’s Hospice, and what we can learn from her determination to improve care at the end of life.
Read more about the life and work of Dame Cicely Saunders at:
If you’d like to join A Year of Reading Dangerously, our online reading group for 2018, there’s still time! Check out the reading list here and start reading along with 1,000 other people around the globe!
Cicely Saunders first began working with dying patients when she was training to be a nurse in the early 1940’s in London. She went on to become an Almoner (medical social worker) and a volunteer nurse at a hospice for the dying poor where she recognized the great need for better pain management and comfort care at the end of life.
When she was told that the medical system would not be interested in her ideas because she wasn’t a physician she accepted the challenge and went to medical school. One revolutionary contribution to end-of-life care was her concept of “Total Pain,” which included emotional and spiritual pain as well as physical.
As a doctor Cicely received a research grant where she studied pain management and wrote many articles. She took “before and after” photos of each patient so that she could show the transformation that occurred when pain was alleviated. Eventually her dream of creating a hospital dedicated to care of the dying was fulfilled when St. Christopher’s Hospice opened 10 years later.
From her story we can take much inspiration for today’s ongoing struggle to improve care at the end of life:
Follow your heart – Cicely stayed true to her heart and passion throughout her career as she dedicated herself to care of the dying, even when others discouraged her.
Be willing to change course to achieve your dream – Cicely was unable to pursue her original dream of being a nurse after a back injury and shifted to medical social work as a way of continuing her work with dying patients.
Be persistent – Cicely’s determination to do whatever it took to bring her dream to fruition led her to become a doctor.
Patience is essential – Cicely had to wait for many years to see her dream of a hospice become a reality: first while she studied to be a doctor, then did several years of research, and finally raised the funds to build St. Christopher’s. Change rarely happens overnight so stay the course!
Be credible before you can be incredible – Cicely demonstrated this throughout her career as she diligently worked through her own education and her research to gain credibility in the eyes of the medical system she was trying to change
The importance of teamwork – Cicely found likeminded individuals in her community and in the U.S. to sustain her inspiration and her enthusiasm for her goal. We can accomplish more as a team than as individuals.
Flexible models are necessary for optimum care – Cicely resisted standardizing her model of hospice care and instead chose to help others create their own unique solutions for the needs of their communities.
Have a big vision but humble expectations – Cicely sought to change care of the dying across the world with her vision of hospice but was content to make a difference to just one patient at at time.
“If one man from a poor village in India dies without pain because of what I have done, it will all have been worthwhile.” – Dame Cicely Saunders
Today we would be advised to remember her Total Pain concept as we struggle to deal with an opioid crisis in the U.S. Neglecting the contribution of emotional and spiritual pain to physical pain has led to over-reliance on drugs as the answer to suffering.
Happy Birthday Dame Cicely Saunders!
Thank you for inspiring us to carry on your big vision of helping every person find comfort, peace and love at the end of life.
Tune in every Monday for a new episode! If you enjoy this content please share with others and consider leaving a review on iTunes. Until next week:
Learn about 10 alternative remedies that are helpful for chronic or terminal pain.
In this episode I’ll share some insights about pain management from a recent blog I wrote in response to the opioid crisis in the U.S. I’ll cover 10 alternative remedies for pain that can be used alone or in conjunction with pain medication. Read the companion blog here (includes links to sources.)
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Thanks to all of my supporters on Patreon.com/eolu who generously contribute every month to help keep this podcast and the End-of-Life University Interview Series on the air! If you’d like to become a Patron for just $1 or $2 per month go to Patreon.com/eolu and join the fun! You’ll receive access to our monthly Hospice Happy Hour Q&A session, the Top 10 Interviews from EOLU, I’ll also promote your website, business, organization, book, etc. related to the end of life on this podcast.
In personal news, I’m busy preparing for my trip to Italy where I’ll be traveling for a month and writing a new book about grief. You can check out my travel plans on my Pinterest board and follow my journey on Instagram and Facebook.
The current opioid crisis in the U.S. has reached epidemic proportions and prescription drug-related deaths now outnumber traffic fatalities and gun deaths. This crisis has been partly fueled by the pressure placed on physicians two decades ago to do a better job of treating pain. Since that time the trend has been for doctors to hand out prescriptions for powerful and addictive opioids for relatively moderate pain when those drugs should be reserved for intractable pain from serious or terminal illness.
As a response to this epidemic I discuss 10 alternative therapies which can help with pain management that can be used alone or in combination with medications. These remedies can decrease the need for drugs and will help improve wellbeing and decrease stress as well:
Exercise and stretching
Loving relationships and sexual intimacy
Prayer and meditation
Emotional Freedom Techniques (E.F.T.)
I’ll discuss each alternative along with the science that supports its use. Hopefully we can learn to manage pain in ways that support overall health of the whole person.
Tune in next week for another episode! Until then …
In this February Update on End-of-Life Issues, Dr. Wyatt will discuss:
Medical schools put more emphasis on pain management education to help reduce over-prescribing of opioid medications, misuse of these drugs and subsequent OD’s, which have doubled in the past decade.
Dementia rates appear to be falling in the U.S. according to a recent report in NEJM due to the level of education and improved heart health of the senior population.
Prison hospices face a challenge in meeting the needs of dying patients for pain medications due to risks of misuse of meds within the prison walls.
Johns Hopkins study published in JAMA shows impact of stress on family caregivers. New website caretransitions.org has tools and resources for caregivers and also to train “care transitions coaches” who can educate community members on the skills needed to become an effective caregiver. Hopefully this will alleviate some caregiver stress and increase the number of available caregivers.
Talk about the newly-released book “When Breath Becomes Air” by 36 y.o. neurosurgeon Paul Kalanithi who wrote the book while dying of cancer.
Emergency care nurse instituted “The Pause” at a UVa hospital after a death in the ER to show respect and acknowledge the loss of life. Trend is spreading to other hospitals.
Similarly a photo circulated on Facebook showing doctors in China bowing to an 11 y.o. boy who asked that, after his death from a brain tumor, his organs be donated to save the lives of others. The medical staff bowed 3 times to honor his bravery and selflessness. Beautiful!
Article about homeless people dying on the streets and the need for options to care for those without suitable homes available as they are dying. Discussed the “social model hospice” option. See Episode 23 from February 1st for more info about the social model hospice.