Perspectives on Care at the Close of Life: CODA
December 19, 2001

Psychological Considerations, Growth, and Transcendence at the End of LifeThe Art of the Possible

JAMA. 2001;286(23):3002. doi:10.1001/jama.286.23.3002

Let it come, as it will, and don't
be afraid. God does not leave us
comfortless, so let evening come.
—From "Let Evening Come," Jane Kenyon (1996)

In June 2001,1 Susan Block, MD, introduced Mr N, aged 77 years, a divorced systems analyst with end-stage pancreatic cancer metastatic to the liver and lungs; Mr N's adult son; and his treating physician, Dr S. Each described the psychological challenges, and illuminated the potential opportunities for personal growth and deepening of relationships, that the end of life offers. Careful attention to Mr N's physical symptoms and suffering made it easier to address his central concerns—about family, his own psychological integrity, and about finding meaning in his life.

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