Literature Review

Why difficult conversations matter: How delivering bad news with clarity and empathy impacts both provider and patient Cedars Sinai, by Cassie Tomlin; 4/8/24Good physicians rely on a battery of hard-won skills to treat serious illness—they observe, predict, test, prescribe and diagnose. But many physicians haven’t been taught how to have productive, mutually beneficial conversations—such as sharing a life-changing diagnosis or informing patients about disease trajectory and symptoms, prognosis and end-of-life care. High-impact communication tools can be learned at any point in a physician’s career, says Jessica Besbris, MD, director of Neuropalliative Care and the Neurology Supportive Care Medicine Program at Cedars-Sinai. Here, Besbris shares why such careful conversations matter for everyone involved, and ways physicians can improve how they discuss serious illness.

The Sunday Read: 'What deathbed visions teach us about living' New York Times Podcasts, 4/7/24 Chris Kerr was 12 when he first observed a deathbed vision. His memory of that summer in 1974 is blurred, but not the sense of mystery he felt at the bedside of his dying father. ... Kerr now calls what he witnessed an end-of-life vision. His father wasn’t delusional, he believes. ... Kerr followed his father into medicine, and in the last 10 years he has hired a permanent research team that expanded studies on deathbed visions to include interviews with patients receiving hospice care at home and with their families, deepening researchers’ understanding of the variety and profundity of these visions.

[Psychology Today] Facing Mortality Honestly Psychology today, by Patricia Prijatel; 4/6/24 Personal Perspective: Being Mortal, by Atul Gawander, explores end-of-life-care. I read Being Mortal by Atul Gawande when it was first published in 2014 and haven’t stopped talking about it. It shot to the top of my list as one of the most important books I’ve ever read. After 10 years, I read it again to see if it held up. It did. I was as entranced the second time as the first—even more so because, as it happens, I am also now 10 years older.

Medicine—Both a Science (Care) and an Art (CARE) JAMA Network - Viewpoint; by Theodore J. Strange, MD and Mario R. Castellanos, MD; 4/3/24In the current era, health care is increasingly characterized by the integration of big data, predictive analytics, medical devices, and artificial intelligence. These technological advancements have undoubtedly transformed the landscape of medical care, offering unprecedented precision and efficiency in diagnosis and treatment. Yet, amidst this surge of scientific innovation, the timeless art of medicine (compassion and caring) remains a foundational aspect of patient-centered health care ... The acronym CARE (compassion, assistance, respect, and empathy) encapsulates these enduring values. ... In a world increasingly driven by data and algorithms, these qualities foster a trusting and supportive relationship between health care professionals and patients, thereby enhancing the healing process and enriching the overall health care experience.

Medical marijuana laws benefit patients without harming public mental health, study finds ScienceBlog, University of Basel; 4/4/24 A study by researchers at the University of Basel has found that the approval of marijuana for medical use in the United States has had little impact on the mental health of the general population, while benefiting those for whom it is intended. The study, which analyzed data from nearly eight million people, sheds light on the ongoing debate surrounding the effects of marijuana legalization on public well-being and its therapeutic value.

The iconic stethoscope is getting a 21st century makeoverManaged Healthcare Executive, by Peter Wehrwein; 4/4/24 Two years ago, a pair of New Zealand physicians wrote an opinion piece in a peer-reviewed journal of the Royal Australasian of Physicians about point-of-care ultrasound. The gist of their argument was that ultrasound ought to be used more routinely to detect various heart and lung conditions. The somewhat cheeky title of that article is “Update on Echocardiography: Do We Still Need a Stethoscope?” Jason Bellet has spent more than a decade making pretty much the opposite case: Not only do healthcare professionals still need a stethoscope, they need a vastly improved, 21st century version that harnesses digital technology and artificial intelligence (AI).

Qualitative analysis of initial palliative care consultations in amyotrophic lateral sclerosis Journal of Pain and Symptom Management; by Christine L Watt, Ian C Smith, Jill Rice, Rebekah Murphy, Ari Breiner, Maria Duff, Danica Nogo, Shirley H Bush, Susan McNeely, Usha Buenger, Belinda Zehrt, Jocelyn Zwicker; 4/2/24, online ahead of print Background: Palliative care (PC) benefits patients with amyotrophic lateral sclerosis (ALS), however the needs of patients and caregivers and the optimal timing of PC discussions remains unclear. This study reports the analysis of PC consult notes from a larger feasibility trial. The specific aims of this analysis were to i) identify the PC needs of patients with ALS via qualitative analysis and ii) identify characteristics of patients and caregivers that could predict specific PC needs.

Integration of palliative care across the spectrum of heart failure care and therapies: considerations, contemporary data, and challengesCurrent Opinion in Cardiology, by Sarah Chuzi and Katharine Manning; online ahead of May 1, 2024 printRecent findings: Patients with chronic heart failure [HF], as well as those who are being evaluated for or who have undergone advanced HF surgical therapies such as left ventricular assist device or heart transplantation, have a number of palliative care [PC] needs, including decision-making, symptoms and quality of life, caregiver support, and end-of-life care. ... PC skills and teams may also help address preparedness planning, adverse events, and psychosocial barriers in patients who have had HF surgeries, but more data are needed to determine association with outcomes.

Art exhibit in Sandy centers experiences of grief OPB, by Sheraz Sadiq; 4/3/24 Art and writing prompts were used during grief support groups offered by Mt. Hood Hospice to help participants process their experience with grief. Dozens of pieces of artwork, poems and other forms of writing created during those sessions are featured in "Grief Made Visible," an exhibit now in its second year that will open on April 5 at AntFarm Café and Bakery in Sandy, OR.

People in this state Googled ‘medical marijuana’ the most, study shows Forbes, by Benjamin Adams; 3/29/24 How inquisitive are people in your state about medical cannabis? A recent analysis aims to find out—ranking states according to the number of Google searches for “medical marijuana” and other related keywords. ... The original study, “Which States Are The Most Obsessed With Medical Marijuana In 2024?” illustrates the levels of curiosity in each state, and some of the findings are unexpected. 

Palliative and hospice care in hospitals and clinics: the good, the bad, and the ugly MedPageToday's KevinMD.com; by Earl Stewart, Jr., MD and Miguel Villagra, MD; 4/1/24 I walk into the patient’s hospital room during evening rounds. He looks pale and tired, having recently completed a round of chemotherapy for his stage IV pancreatic cancer. His wife is at the bedside, scared and concerned about her husband’s rapid decline. I sit down to discuss goals of care when the patient immediately says, “I can’t do this anymore.” His wife responds immediately to the patient: “Of course you can.” ...

Autism & Grief Project helps autistic adults navigate death and lossCision PRWeb, by Autism & Grief Project; 4/1/24 Launched by the Hospice Foundation of America and supported by the NLM Family Foundation, the project bridges resource gaps for adults on the autism spectrum. The Autism & Grief Project is an online platform supporting autistic adults as they navigate the complexities of grief arising from death and loss. Visitors can access free resources for adults, their families, professional support providers, and clergy members: austismandgrief.org.

Cancer patients often want ‘one more round.’ Should doctors say no? The Washington Post, by Mikkael A. Sekeres, MD; 3/31/24 My patient was in his early 30s and his leukemia had returned again following yet another round of treatment. He was a poster child for the recently reported rise in cancer rates in the young, and had just asked me what chemotherapy cocktail I could devise for him next, to try to rid him of his cancer. I hesitated before answering. Oncologists are notorious for always being willing to recommend to our patients one more course of treatment, even when the chances of success are negligible.