Pandemic as teacher : forcing clinicians to inhabit the experience of serious illness

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DELIMA THOMAS, Jane

In palliative care, one of our favorite tools is the maxim “Hope for the best, prepare for the worst.” We wield it frequently, sometimes indiscriminately, when faced with patients who assert that “It isn’t time for palliative care yet.” We respond by saying something like, “We will continue to hope for [cure/disease response/transplantation/other positive outcome] and help you feel as well as you can. At the same time, we want to prepare just in case [cure/disease response/transplantation/other positive outcome] isn’t possible.” And with that, we encourage patients to begin addressing practicalities such as selecting a health care proxy and making sure bank-account passwords are accessible to next of kin — just in case. We liken this kind of preparation to car insurance: Buying car insurance doesn’t cause you to get into an accident, right? Well, making plans in case things don’t go well doesn’t cause them not to go well. It’s the same idea. And then came Covid-19, and I, like many physicians, started to understand things differently. As clinical director of a large palliative care program in Boston, I read the reports from Wuhan, Bergamo, and New York, and I knew we would face challenges unlike any we had faced before. I was responsible for preparing our group to take care of the wave of critically ill and dying patients that would arrive on our doorstep soon, and I began to strategize. [Début de l'article]

http://dx.doi.org/10.1056/NEJMp2015024

Voir la revue «The New England journal of medicine, 383»

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