TY - JOUR
T1 - Sitting with you in your suffering
T2 - Lessons about intractable pain at the end of life
AU - Sudore, Rebecca L.
AU - Villars, Patrice
AU - Carey, Elise C.
PY - 2010/6/1
Y1 - 2010/6/1
N2 - This paper describes a case of a hospice patient that a hospice and palliative care team struggled to palliate. We review a case of a 63-year-old man with anal squamous cell carcinoma who was transferred from an inpatient hospice unit to an intensive care setting in an ill-fated attempt to alleviate his pain and suffering. This paper also describes the frustration and desperation on the part of his medical and interdisciplinary team to provide him adequate relief. In retrospect, there were likely many system factors that may have contributed to this patient's ongoing suffering, including restrictions on the use of certain medications by location (i.e., hospice unit versus intensive care setting) as well as medication and ordering misunderstandings. Opiate neurotoxicity, existential and spiritual angst, and social isolation also contributed substantially to this patient's suffering. Furthermore, we describe not only the importance of exhausting all medical resources to relieve patients' pain and suffering, but also of learning to sit with patients in their suffering.
AB - This paper describes a case of a hospice patient that a hospice and palliative care team struggled to palliate. We review a case of a 63-year-old man with anal squamous cell carcinoma who was transferred from an inpatient hospice unit to an intensive care setting in an ill-fated attempt to alleviate his pain and suffering. This paper also describes the frustration and desperation on the part of his medical and interdisciplinary team to provide him adequate relief. In retrospect, there were likely many system factors that may have contributed to this patient's ongoing suffering, including restrictions on the use of certain medications by location (i.e., hospice unit versus intensive care setting) as well as medication and ordering misunderstandings. Opiate neurotoxicity, existential and spiritual angst, and social isolation also contributed substantially to this patient's suffering. Furthermore, we describe not only the importance of exhausting all medical resources to relieve patients' pain and suffering, but also of learning to sit with patients in their suffering.
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U2 - 10.1089/jpm.2009.0325
DO - 10.1089/jpm.2009.0325
M3 - Review article
C2 - 20509794
AN - SCOPUS:77954449799
SN - 1096-6218
VL - 13
SP - 779
EP - 782
JO - Journal of Palliative Medicine
JF - Journal of Palliative Medicine
IS - 6
ER -