when serious illnesses take us to hospitals we looked at doctors for
answers
what happens when there are no more cures and do you want to call her
daughter
sorry Cooper is an emergency surgeon with palliative care training at Brigham
and Women's Hospital in Boston
she frequently must deal with patients surprised that they're nearing the end
of life
it's certain that everybody's gonna die there's no certainty as to win the CT
scan was what's going on and was frequently as an emergency surgeon
I'm meeting somebody for the first time and they have no idea that they could
die from the disease whether that's because nobody's told them or they're in
denial
I don't know but it's always a surprise
slide Earl has been undergoing treatment for advanced cancer for a year
he is now suffering with intense pain the prognosis is not good
well you're in good hands here dr. Cooper dr. Cooper wants to talk to mr.
Earl and his wife Audrey about what comes next
the rumor has it you guys are newlyweds is that right huh yeah that's great but
now what happened before you came into the hospital
one morning I had so much pain i could not take it
I was gonna be trouble yeah 33 game yeah
what I discovered was that he and his wife had the expectation that he had
many more months
so let me ask you what do we expect to happen after you leave the hospital with
a mission
ok we're going up dial to name ok ok and then that the main world will go back to
house in Florida right right now has anybody talked to you about a hospice or
having hospice nurses take care of your is that part of the plan
women if we need it right I know the first agent yeah when I said hospice
It was as if i was talking to somebody who only thought that hospice would be
necessary when he was just about to die
my impression was that that was the goal was to get him dogs
i think the lesson learned is that you have to ask you can't make those
assumptions because oftentimes patients and their families aren't at all where
you think they are and aren't at all where you think they should be bizarre
Cooper had at least started a conversation about the end of life
we are here to take care of you okay all right is Clyde girl's condition worsens
dr. Cooper brought in Kathy selvaggi a senior palliative care physician whose
expertise is in end-of-life care she would now take up the hospice discussion
she and I had a conversation about goals of care and we went
dr. symbology came down to the ICU to meet them
I said you know you've got a lot of work two dishes that I know
it was really important to take his wife aside and talk about what I was seeing
hi
there's no matter what like that
I why the morning
it's been like that
yeah
like I know about to get a little
it is a process
and I think you know it is very hard to come to the realization that you're
dying
these are really important conversations that should not be waiting
the last week of someone's life I'm not sure I'm going to get him back to me
without I think the truth I don't think we are all know I think he's going to be
here with us
yeah I know you
I got time with him out but it's my old world
I think you're never gonna pick my heart oh I knew better
I do what with the hand oh and i think with it's those moments when people show
that they want to talk about it
once somebody gives you that kind of opening in palliative care were trained
to take that opening and to identify that as a moment where you can help
somebody
whereas I think the natural inclination is to say we're going to get him better
you're going to get him home because it makes you feel better
I mean
yeah