Hektoen International

A Journal of Medical Humanities

Tag: Spring 2011

  • Streptococcus and me

    Andrea MeyerhoffBaltimore, Maryland, United States I respect the streptococcus. It is a bacterium—a whole genus of them—that excels at making people sick. It may shape a childhood understanding of illness, rupture ties that bind a family, or drive an appreciation for a great moment of human achievement. More recently, however, the memory of a particular…

  • The US hospice movement: Redressing modern medicine

    Emily BetheaChicago, Illinois, USA Unlike its modern concept, hospice began as “a house of rest and entertainment” not only “for pilgrims, travelers, or strangers” but also “for the destitute or sick.”1 Like the images conjured by these words, the first hospices are believed to have originated in the 11th century when the Crusaders permitted the…

  • End-of-life care and contingent vs. non-contingent duties

    Ronald W. PiesBoston, Massachusetts, United States Introduction Mr. Joseph B, a 70-year-old widower and retired college professor, is hospitalized in the final stages of metastatic pancreatic carcinoma. His doctors estimate that he has “three or four weeks” to live. The patient is well aware of his prognosis, and, as he puts it, “I have come…

  • Must life always be prolonged?

    Patrick D. GuinanChicago, Illinois, United States This is an open-ended question and, for that reason, difficult to answer. We agree that life is a natural good and should not be willfully terminated (self-defense and a just war being exceptions). But in many instances life can be prolonged, almost indefinitely, by such means as parenteral enterostomal gastrostomy…

  • A dying patient’s perspective on truth-telling

    Shimon M. GlickBeer Sheva, Israel Mr. H, a 60-year-old farmer with liver metastases from a gastric carcinoma, had been in the hospital for quite some time. Jaundiced from his condition, he turned to one of the residents on rounds and said, “Several days ago, I asked you how much time I have to live, and…

  • The good death

    Raeford E Brown, JrLexington, Kentucky, USA Physicians and nurses experience death all too often. We recognize the gray hue, the fetid odor, and chill of a body that has been failing for days or months. In hospital halls, we hurriedly pass families as they struggle to deal with the loss of their loved ones. In…

  • Our father who art on Earth, still

    Peter SullivanRochester, New York, United States She didn’t like the way he just stood there, staring. First it was at the sink, looking out the window, holding a just-lathered dish midair with the water running. Then later in the evening he’d sat in the LazyBoy, which faced the living room TV. From time to time,…

  • Time

    Paul RousseauCharleston, South Carolina, United States Selfishly, time is either too short or too long, the moment never appreciated. Mrs. Jones was a 69-year-old female with widely metastatic ovarian cancer, diagnosed during an emergency room visit for abdominal pain. After consultation with an oncologist, she elected to forgo chemotherapy and was referred for palliative care.…

  • Turning points

    Loretta S. DownsChicago, Illinois, USA My mother’s end-of-life was 15 years long. It began the day my father died and she became dependent upon her children to fill the roles he had played throughout their 61-year marriage. We managed relatively well, and her health continued to be good for nearly seven years. By the time…

  • A Christmas party

    Loretta S. DownsChicago, Illinois, USA A war started the day my mother was forced to move into a nursing home. After years of slow progression, the stenosis in her back refused to let her live independently any longer. From the moment she arrived, I spent five days a week trying to help her adjust—hoping she…