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A Piece of My Mind
September 10, 2019

Don’t Fear the Reaper

Author Affiliations
  • 1Perelman School of Medicine, Department of Dermatology, University of Pennsylvania, Philadelphia
JAMA. 2019;322(10):929-930. doi:10.1001/jama.2019.12602

I knew my grandma Eleanor couldn’t have many years left. She was 96, and though her mind was unrelenting, she was increasingly physically frail. The last several years, I tried hard to savor every time I saw her or spoke with her on the phone. Do you know that feeling, when you know every conversation might be your last? Do you hold on to voicemails, just so you have a recording in case they die?

As the only doctor on her side of the family, I was my grandma’s default resource and advocate. But I also learned more about medicine from my grandma than from any rotation in medical school.

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    4 Comments for this article
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    Thank you
    Marsha Epstein, MD MPH | Retired
    Thank you for your honest sharing of your grandmother's death. I did the same for my mother and grandmother. I hope it inspires more readers to do the same.
    CONFLICT OF INTEREST: None Reported
    A Funeral Today
    Warren Heymann, MD | Cooper Medical School of Rowan University
    My mother-in-law's funeral was held today. She was just a few years younger than Dr. Lipoff's grandmother, and of a similar opinionated, sassy ilk. Given her many maladies over the last several years, her resilience was remarkable, despite the inevitable downward spiral of multiorgan demise. Yet, at the end, she knew it was her time and asked to be let go. We were with her during her final agonal breaths, blending sorrow and relief simultaneously. Thank you Dr. Lipoff for reminding us of the value of controlling our destiny by our desires and expectations even at the termination of life.
    CONFLICT OF INTEREST: None Reported
    You are Human
    Betsy Schmidt, BSN | Director of Nursing in Bristol, PA
    Yes Doctor Jules, you" did do the right thing" by your loved one. As a previous critical care nurse and then hospice nurse manager I became a good listener and caregiver of the human kind. I loved my job with all my heart and I treated all of my patients with the utmost care and respect as if they were my own family. Your grandmother knew right from the beginning that you cared, that is why you eventually were her primary caregiver; funny how that works out. You listened. You had a heart. It was normal for you to scrutinize all of her care. That's how I look at all of my peeps: as if I were doing it to myself. Do unto others, remember? Some people forget those little words, but they are so meaningful. Keep on doing what you do. Your grandmother instilled in you the very best of her, and it shows. Your patients are lucky to have you.
    CONFLICT OF INTEREST: None Reported
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    Reminders
    Carrie Kovarik, MD | Perelman School of Medicine, University of Pennsylvania
    Thank you to Jules and his Grandma for these reminders (although there are many more I could list!):
    - Giving patients the option of opting out of treatment can be a reasonable choice.
    - In medicine, its OK to tell patients "I don't know"
    - Most of all, live life to the fullest with those you love
    CONFLICT OF INTEREST: None Reported
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