Literature Review

Sabbaticals provide a critical lifeline for sustainable medical careers [podcast] MedPage Today's KevinMD.com; podcast by KevinMD; 2/14/26 Palliative care physician and certified physician development coach Christie Mulholland discusses her article “Why every physician needs a sabbatical (and how to take one).” Christie reveals the harsh reality that while sabbaticals exist on paper, unwritten rules often prevent doctors from accessing this critical recovery tool until it is too late. She shares her personal journey of taking an unsanctioned, unpaid break to combat burnout and how that decision allowed her to return to medicine with renewed purpose. 

What can we learn from death in the age of longevity? Time; by Arianna Huffington; 2/16/26 ... Research on those at the end of life shows that our values change as death approaches. At the end, we don’t crave more status or more things, but more connection. A study on terminally ill patients found that common reflections include concern for loved ones, gratitude, and spirituality. Another found that the most commonly discussed topics included accepting one's imperfections, celebrating and appreciating what you have, giving, and service to others. And a study of hospice patients found that they showed “the desire to grow and change at this critical time.” If hospice patients can grow and change at the end of life, why not grow and change now? ... It is a surprising, but important, lesson to learn: bringing death into our lives is what paradoxically allows us to live more fully.  

Palliative external beam radiation therapy for dysphagia in a 101-year-old man with esophageal adenocarcinomaCureus; by Pericles J. Ioannides, Jester M. Odrunia, Gina N. Perez, Morgan Butow, Georg A. Weidlich; 1/26Esophageal adenocarcinoma in centenarians is rare, and treatment options in this age group are limited. We present the case of a 101-year-old male patient with symptomatic distal gastroesophageal junction (GEJ) adenocarcinoma who presented with progressive dysphagia, aspiration, and weight loss. The patient underwent palliative external beam radiation therapy (EBRT) ... targeting the obstructive esophageal mass with a margin using volumetric-modulated arc therapy (VMAT) technique. The treatment was well tolerated by the patient with no significant acute toxicity. After treatment, the patient reported clinically meaningful improvement in functional status, with improved swallowing, advancing from liquids to a soft diet, weight gain, and improved QoL. Moderate-dose palliative radiation can be a safe and effective treatment in a centenarian with obstructive GEJ adenocarcinoma, particularly when endoscopic interventions are not successful or durable.

Florida’s rigid drug policy leaves cancer patients in pain | Column Tampa Bay Times, Tampa, FL; by Deborah Schofield; 2/11/26 Michelle was newly and suddenly diagnosed with stage IV cancer. She had pain every day. And in Florida, that made her suspicious. Despite a terminal diagnosis, ... [when] a prescription for Percocet was finally written, the reality of Florida's system came sharply into focus. Nine pharmacies - major national chains including CVS and Walgreens - told us they did not have the medication and could not say when they would. Nine. ... Eventually, hospice became involved. Only then did Michelle receive more consistent pain control. Yet even hospice was not immune to the system's failures. ... If Florida wants to lead on opioid policy, it must also lead on humanity. That means explicit protections for cancer and hospice patients, clearer regulatory distinctions between acute pain and end-of-life care, and accountability across pharmacy supply chains.

How an ethics course can prep you for med school: It can strengthen communication and empathy and help with complex treatment and research decisions. U.S. News & World; by Neha Raju; 2/10/26 Medical school applicants often focus on the most tangible parts of preparation: grades, MCAT scores, clinical hours and research. Ethics courses, when considered at all, are sometimes treated as peripheral or “nice to have” rather than genuinely useful. That view misses how central ethical reasoning has become ...

Spreading the principles of palliative care to all corners Health Affairs; by Jessica Nutik Zitter; 2/2/26 My daughter Sasha is a first-year medical student. ... Most recently, she has been envisioning herself as a palliative care physician. She tells me it may be the only specialty that will allow her to practice her values. As a long-time palliative care physician who has acted as an evangelist for the specialty, I surprised myself with a reflexive response. “I’m not sure that’s the best choice for you,” I said. ... Something needs to change—for our patients and for ourselves. ... I propose several strategies ...

Hospice clinicians' approaches to terminal restlessness: A qualitative analysisJournal of Pain & Symptom Management; Andy Jan, Molly Turnwald, Susan Maixner, Thomas O'Neil, Lauren Gerlach; 1/26Terminal restlessness is frequently observed in hospice, yet it lacks a consistent definition, diagnostic framework, and treatment approach. Five themes emerged [from this study]: (1) Diagnostic challenge-clinicians reported difficulty distinguishing terminal restlessness from delirium, pain, or medication side effects; (2) Common symptom profile-agitation, confusion, hallucinations, and constant movement; (3) Temporal association with active dying process-terminal restlessness was viewed as a sign of imminent death; (4) Ruling out reversible causes-pain, urinary retention, or other modifiable factors; and (5) Treatment variability-approaches varied, though most clinicians were more comfortable using sedating medications once death was perceived to be imminent.

Programs that pair older-adult mentors with medical students aim to overcome ageism Association of American Medical Colleges (AAMC); by Bridget Balch; 2/4/26 ... About 1 in 5 people over age 50 report having experienced age discrimination in a health care setting, according to a 2015 study. It’s an issue that researchers at Yale School of Public Health estimate costs the health care system $63 billion a year and can have serious negative effects on the physical and mental health of those discriminated against. As the proportion of the population over age 65 is increasing rapidly, some medical schools have developed senior mentoring programs that pair medical students with older-adult mentors to help overcome stereotyping and ageism, and to give older adults opportunities to engage with and give back to their communities.

“This is what loneliness looks like”: A description of a high-risk population of palliative and oncology patients American Journal of Hospice and Palliative Medicine; by Tamia Ross, MSPH, Ruwanthi Ekanayake, BA, Lucy Rabinowitz Bailey, MPH, Kain Kim, MD, and Emily Pinto Taylor, MD; 1/9/26 Background: Loneliness exacerbates symptom burden and reduces quality of life in serious illness. Social prescribing–linking patients to non-clinical community activities–offers a novel approach to address loneliness in palliative care. Results: Most patients were older, non-Hispanic Black women experiencing financial strain, food insecurity, and transportation barriers. Anxiety exceeded depression severity; mood disorders, loneliness, and social isolation were leading referral reasons.

Sheinelle Jones honors nurses who cared for her late husbandTODAY with Jenna & Sheinelle; YouTube segment from tv show; 2/4/26 TODAY's Sheinelle Jones pays special tribute to the nurses and caretakers who looked after her husband Uche Ojeh while in hospice and not only made the time he had left more comfortable, but also supported her and the whole family during their most difficult moments. "The only reason I even have the strength to talk about it, is because I believe that they're our heroes. They deserve all the love and attention we can give them," she says. Then, the care team, Jazzie Stickle, Denise James Wright, Nykyra Owens, Chanel Duff and Jessica Goldstein, get a special surprise.Editor's Note: This segment on TODAY with Jenna & Sheinelle honored Uche's birthday, the first birthday Sheinelle and her family are experiencing since his death from brain cancer in May 2025. Hudson Valley Hospice provided hospice care, and beautifully represented the best of hospice care's philosophy and care. In addition to nurses and aides, Sheinelle especially thanked Uche's speech pathologist who helped him voice "I love you." I invite you to watch this and be inspired:  Sheinelle Jones' late husband Uche relearned to say 'I love you' in hospice. And she has the video.

Medical expertise does not prevent caregiving grief Medpage Today's KevinMD.com; podcast hosted by KevinMD; 2/2/26 Triple board-certified physician in adult and geriatric psychiatry and addiction medicine ... Barbara Sparacino shares the personal struggle of navigating end-of-life care for her own parents despite her extensive professional training. She explains the “prophet in your own country” paradox where family members often dismiss medical advice from their own relatives. The conversation explores the heavy guilt and self-doubt that arise when the professional detachment of a doctor collides with the emotional vulnerability of a child.  Barbara highlights the importance of setting boundaries to protect the parent-child relationship and offers advice on extending grace to oneself during this difficult season. Discover how stepping back from the physician role can actually be the greatest gift you give to your aging family.

De-mystifying performance measures for hospitalists: Mortality The Hospitalist; by Matt Cersale, ND, MPH, SFHM; Kristin Gershfield, MD, FHM; Preetham Talari, MD; Anunta Virapongse, MD; 2/2/26 Mortality is the ultimate outcome metric for patient care. In the hospital, measuring mortality appears simple and straightforward, but upon considering the layers of attribution and risk stratification, it becomes significantly more complex. Measures of mortality are used in various quality reporting and national ranking programs, making them a common focus of hospital leadership. However, the connection between hospitalists and measures of mortality is not always clear.