In honor of Dia de los Muertos, what’s a clinical excellence pearl you learned caring for a former patient?

Rachel Salas, MD, Johns Hopkins University School of Medicine

One thing I learned is to enjoy life daily (or at least try – sometimes is can be difficult). It is easy to get down on the things not going the way we want in our own lives. I learned from my patients that have passed that my life is a gift and to remember that I am alive and able to spend time with my family and friends.

Margaret Chisolm, MD, Johns Hopkins University School of Medicine

Many years ago, I learned the importance of not taking on ‘acquaintances’ as patients – even for seemingly routine antidepressant med maintenance – after one such young patient died of a cardiac arrest related to the med. Our relationship suddenly seemed much closer and guilt was immense.

Panagis Galiatsatos, MD, Johns Hopkins University School of Medicine

I learned the power text messages. I used texting to have daily contact with a patient regarding her symptoms in order to fulfill a promise of keeping her out of the hospital. She would message me her symptoms and weight and I would adjust her therapy. We did this for 2.5 years until she passed away one week shy of 90. This taught me the significance of connectivity with my patients and how strategies beyond just clinical appointments can help patients achieve their health goals.

Shannon Scott-Vergnalia, Massachusetts General Hospital

I took care of special boy who died of neuroblastoma when I was a resident. I sat with his sister as his mother wept the night he died. Distraught, and leaving the floor with the senior oncologist, he told me it never gets easier to lose a child. He was right.

William Greenough, MD, Johns Hopkins University School of Medicine

Mrs. M had severe restrictive lung disease and was short of breath even on the ventilator, requiring morphine for symptom control.

She tolerated this severe discomfort for several years, was an avid reader, sharing all of the Dick Francis novels with my wife, but as her condition worsened decided she had had enough and asked to being taken off the vent (life support).

With great reluctance I agreed and was late to get to the bedside on the appointed day. She chastised me in her friendly manner for being late for such an important occasion and died peacefully within a few minutes of withdrawing ventilator support.

I learned from her that no matter how much I might want keep someone alive that I should listen to my patient and follow their wishes, setting my own aside.

Scott Wright, MD, Johns Hopkins University School of Medicine

Several of my patients have been able to reach an appreciative perspective when looking back at the highlights and joys that filled their years. With many others who are rather sad and somber, I have tried to gently nudge them towards this more grateful and positive stance as they approach the end.

Mike Fingerhood, MD, Johns Hopkins University School of Medicine

A patient with untreatable cancer saying to me, “make sure I die with dignity.”