[Skip to Content]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address Please contact the publisher to request reinstatement.
[Skip to Content Landing]
Views 1,413
Citations 0
The Arts and Medicine
December 3, 2019

Terminal Delirium in the Opera Kopernikus

Author Affiliations
  • 1Temmy Latner Centre for Palliative Care, Sinai Health System, University of Toronto, Toronto, Ontario, Canada
JAMA. 2019;322(21):2058-2059. doi:10.1001/jama.2019.18865

My patient was actively dying—unfocused eyes opening and closing, brow furrowed. She was speaking urgently, but her words only emerged as softly articulated sounds in the back of her throat. With each inhalation I heard the crackling of uncleared respiratory secretions. Each exhalation came with a long moan as her vocal cords collapsed together in fatigue. After quick consultation with her husband and friends who were gathered in her bedroom, I pressed a syringe full of midazolam under her skin. In a few minutes her eyes were closed, and she was breathing more easily. One of her friends asked me what was going on inside her head. Could she still hear them? Was she still present or somewhere else? As a palliative care physician, I’m asked these questions frequently. I told them that I didn’t really know, but I liked to think that she was somewhere in a deep, peaceful dream.

Limit 200 characters
Limit 25 characters
Conflicts of Interest Disclosure

Identify all potential conflicts of interest that might be relevant to your comment.

Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.

Err on the side of full disclosure.

If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.

Not all submitted comments are published. Please see our commenting policy for details.

Limit 140 characters
Limit 3600 characters or approximately 600 words