Should I Help My Patients Die?

By Dr. Jessica Nutik Zitter Source: The New York Times OAKLAND, Calif. — I WAS leafing through a patient’s chart last year when a colleague tapped me on the shoulder. “I have a patient who is asking about the End of Life Option Act,” he said in a low voice. “Can we even do that here?” I practice [...]

2017-10-23T19:36:41+00:00August 5th, 2017|

Ask The Expert: How Do You Handle End-of-Life Care in a Patient Who Does Not Know They Are Dying?

By Dr. Jessica Nutik Zitter Source: Practical Pain Management Unfortunately, many patients with a terminal illness who are referred for procedural or medical treatment of refractory pain will not be aware that they are dying. There is a common resistance among physicians to communicate bad news, particularly with regard to impending death.1 In my book, Extreme Measures: Finding a Better [...]

2017-10-23T21:32:44+00:00May 1st, 2017|

Misleading Metrics

By Dr. Jessica Nutik Zitter Source: Health Affairs Blog A few years ago, while at a family get-together, I sat across from a retired hospice social worker named Terry. I am a physician whose practice alternates between attending on the wards of an inner-city intensive care unit and serving as a consultant on the hospital’s palliative care team. [...]

2017-10-23T22:04:23+00:00February 21st, 2017|

Err on the Side of the Patient

By Dr. Jessica Nutik Zitter Source: Huffington Post I was almost run over by a gurney being pushed by a fast-moving Emergency Medical Technician. He thrust the patient’s chart at me. “Doc, you’ll want to check this lady out quick. She’s not looking good.” The first thing I noticed was the color of her skin. Its greyish green hue [...]

2017-10-23T21:50:14+00:00November 6th, 2014|

A Doctor’s Dilemma

By Dr. Jessica Nutik Zitter Source: Pulse It was my first day at my new job, practicing a new specialty. Having spent fourteen years as an ICU physician--including a four-year pulmonary/critical-care fellowship in this very hospital--I had just completed a palliative-care fellowship. Now I was the hospital's palliative-care consult attending. When I set eyes on the patient in [...]

2017-10-13T21:26:00+00:00September 12th, 2014|

Who Can Speak for the Patient?

By Dr. Jessica Nutik Zitter Source: New York Times Well Blog Our patient was never going to wake up. He had an unrecoverable brain injury. The prognosis had become clear over time. As the patient’s attending physician in the intensive care unit, I arranged a meeting with his sister, the only visitor we’d seen for days, and explained. She [...]

2017-10-23T21:54:30+00:00June 19th, 2014|