Care in the final days

I was deeply moved by the article about BJ Miller ’93 and his work at the Zen Hospice Project (Princetonians, Feb. 5). I remember hearing about his accident after I left Princeton and am delighted to know that he not only survived but has flourished, despite his injuries.

I, too, practice palliative and hospice medicine, in my case after a career in anesthesiology. Palliative and hospice medicine was but a twinkle in a few visionaries’ eyes when I graduated from medical school in 1983. 

Although I started out enjoying anesthesiology, over time I began to feel like an accomplice to the mere shuttling of terminally ill patients back and forth from operating room to ICU until they died. The price was enormous suffering for them and their loved ones, tremendous expense to society, and a less tangible but profound toll on the morale of staff providing what they knew to be futile care.

While my years of experience with techniques and medications for the relief of pain certainly come in handy in palliative and hospice care, Dr. Miller is right in noting that simply bearing witness to one another’s mortality is a huge part of our job. It is a practice at which our culture has become quite out of practice.