Palliative Care in 15 minutes

One day I was called by an acquaintance to do a favor. She proceeded to tell me that her friend, a prominent Pulmonologist in his hospital, had his mother on hospice care and was having a difficult time with the situation. Although the patient was comfortable (symptom free), with the son (doctor) giving the patient routine doses of morphine and ativan to assure her comfort, the son was not coping well with the situation. The friend had asked him to call the palliative care team when his mother was in the hospital but he didn’t believe in palliative care and thought palliative care would only expedite his mother’s death. Once his mother was on hospice, the friend again, asked him to reach out to the hospice physician for support and guidance but this was met with resistance. Finally, things reached a boiling point and he was open to talking to someone. I agreed to call him at the request of the acquaintance. We briefly discussed his mother’s current situation and it appeared that the patient was actively dying and the son was appropriately giving her the routine medications for comfort. At some point during our conversation he blurted out “I just need someone to tell me I’m doing the right thing!” I told him that in fact his mother was actively dying, he was appropriately giving him the medication and that he was honoring his mother’s wish of dying comfortably at home with her family around her. We also discussed possible time frame for her passing. The conversation was about 15 minutes long and held while I was a passenger in a car. I later learned that the patient passed comfortably within 24 hours and after our conversation the son was at peace with the situation and felt relieved that a “Palliative Care Doc” let him know that he was appropriately caring for his mother. He stated that if a 15 minute conversation on the phone could make him feel as calm and comforted, what positive effect would have taken place with him, his family and mother if he would have allowed the palliative care team to be involved sooner. After this experience he vowed that he would be a champion of palliative care and make palliative care more accessible to his patients, recommend palliative care involvement to his colleagues and call the palliative care team sooner in the course of a patients hospitalization.