His wife said, “I couldn’t wake him from his nap.”  The coroner told her he died in his sleep without moving a muscle.  His family doctor told me that Parkinson’s had slowed him greatly in the past year.

He was 81, and the day before, he had enjoyed the usual lunch with friends. His multi-lead pacemaker was devoid of high voltage shocks.  Whether shocks would have made a difference is completely unknowable.

His wife said she was so grateful he didn’t suffer.  Me too.

I wonder how many electrophysiologists are married to a practitioner of palliative care?  How many of us installers of life-prolonging devices see, or hear of, the human suffering in those patients unlikely enough not to have sudden ventricular fibrillation?  How many cardiologists know that the locked dementia ward of a local nursing home is cruelly named, Paradise Island.

I can learn from a wife.  She practices palliative care and hospice. Some may consider this an emotionally draining field.   Indeed it is sometimes, but her stories detailing the relief of human suffering are seemingly boundless. As a younger doctor, I recall thinking hospice practice was gloomy and dark.  Like everything in life, knowledge serves to illuminate. To relieve human anguish is the opposite of gloom.

“You always call the family of the deceased…Isn’t that really hard,”  I ask.

“No, it helps a lot.”  

The common sense lessons of palliative care are applicable to all aspects of medical practice.  Like calling the family of the recently deceased, so as to express sympathy. This simple phone call is a given for some, but for an installer of life-prolonging cardiac devices, death is not easily or readily acknowledged.  It is uncomfortable, like a mistake or failure.

But I have called three times this year.  Each phone conversation has been well received.  Each is less scary than the previous.

I am learning.  This is good.

JMM