How Medicine Heals Patients Permanently: End Of Life Decisions


I’ve been a doctor for decades. Always hoping to heal my patients.

But, now, I’m on my way to sit with somebody as she dies.

Experiencing a patient’s death is not the reason I became a doctor or, at least, that’s what I would have told you early on in my career.

But I’ve learned a lot about what it means to be a doctor through the ages, stages, and phases of life and diseases.

I’ve learned how medicine can heal a patient in a way that is permanent.

When my patient, Jennifer, passes, I’ll also be with her husband of 37 years and a hospice social worker. My patient will be taking a combination of medications I prescribed for her, and she will go to sleep and stop breathing. And then her life as we know it will be over.

Right now, how does that make you feel? Does end of life scare you? Do you worry about yourself or your loved ones suffering at end of life?

For me, the feelings are immense. I recognize that something extremely powerful will happen–something that once it’s done can never be undone.

I feel sad that medicine can’t take away Jennifer’s terminal illness.

I’m empathetic for her continuous struggle and I understand her decision to no longer live this way.

I’m honored to support and guide her through the process.

I’m happy that I live in California, a state where people have the ability to choose how and when to die if a certain death is inevitable.

I’m anxious because I want everything to go smoothly and be pain-free, and I know I’m not in complete control of that.

My drive feels longer than usual. My mind is filled with words to say to my patient, things to do when I arrive. I know there will be heartfelt hugs, tears, and maybe more questions. After all, I only met this lovely woman a little more than two weeks ago.

A hospice agency gave her and her husband my name. She has a rapidly progressive neurological disease that is stripping away the ability to function. It’s only a matter of weeks or months before she will be physically unable to take medication on her own.

If she does nothing, she will likely not be able to swallow soon.

She will become completely bedridden, dependent on artificial feeding, and total care from others.

For a person who was incredibly active and independent, who ran numerous marathons, this fate would be beyond acceptable.

As a doctor, I’ve often thought about my patients’ circumstances and wondered what I would do If I were in their situations.

This time, I know, I would choose to end my life as Jennifer is going to do.

Before reaching out to me, Jennifer’s husband had been unsuccessful in finding a physician who would support this.  They called at least fifteen different doctors, none of whom would help.

For doctors, there is significant fear around the aid-in-dying process and uncertainty about issues related to liability and public perception.

But in my practice, Integrated MD Care, I get to know patients intimately. Through on-going visits and conversations, I become aware of their deepest desires.  I come to understand them, and they come to trust me.

My concern isn’t about liability issues. I am completely and singularly focused on doing what is in the best interest of my patients and their families.

And sometimes that means helping them with an end-of-life experience.

Being able to peacefully end their life gives my patients the power to decide how and when they actually die.

For me, it’s an opportunity to do good in the world when medicine has failed them so far.It’s done.

I’m driving home after sitting with Jennifer as she drank the medicine, then gently fell asleep and exhaled for the last time. Before she drank it, we chatted comfortably about the weather, my family, her family, and her hopes that she would be entering a beautiful and peaceful afterlife. She was anxious to see what awaited her (ultimately awaits all of us.)

Jennifer’s husband showed me pictures of her as a teenager and of them as newlyweds over 30 years ago.

The end of life is sad, but watching Jennifer’s disease destroy her body made everyone sadder.

For Jennifer, there was no hesitation. She had complete love and support. She drank the medication easily, and within 30 minutes, she had peacefully stopped breathing, her pain and limitations gone.

And instead of sorrow, a celebration of life happened. The peaceful transition from a world of struggle, pain, and no hope was gone with one drink. Now the honoring of a woman who lived life to the fullest and ended her life the way she intended begins.

I am in awe and humbled to be a part of a transition that has brought an entire family peace.

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