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C L O S L E R
Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative
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Creative Arts in Medicine
Connecting with Patients
Passion in the Medical Profession
Lifelong Learning in Clinical Excellence
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February 13, 2024 | 3 min read

Unsent letters from a palliative care doctor to a patient and her dog 

By Lingsheng Li, MD, MHS, University of California, San Franscisco

Sometimes we never get the chance to tell a patient what we admire about them. After my patient died, I realized I’d been inspired by the inner strength she showed by caring for her dog despite health and life challenges. 

January 30, 2019 | <1 min read

Dr. David Wu, A CLOSLER Look

By Gretchen Miller, Managing Editor

Palliative care is an approach to medicine that focuses on quality of life. My hope is that every clinician learns basic palliative skills to lead family conversations when there is a critically ill patient. It's a precious privilege to be able to enter people's lives at their most vulnerable time, and help them find some kind of peace.

July 6, 2021 | 2 min read

CARE: Connect, Assess, Respond, Evaluate

By Cheryl Barnes-Neff, PhD, MDiv, RN, President, Laurel Oak Group, Online Education & Training

To understand and better care for your patients, be curious about their life stories. Reflect on what you hear and consider the extent to which you are truly connecting.

July 7, 2021 | 1 min read

Lessons Learned During my Palliative Care Rotation

By Rayah Sawaya, MD, American University of Beirut

In the wake of disaster, I witnessed the value of palliative care firsthand. This service prioritizes patient comfort and end-of-life preferences.

July 10, 2023 | 3 min read

Dying With Peace And Joy 

By Lillie Shockney, RN, MS, Johns Hopkins Medicine

Empowering your patient to be the ultimate decision maker about all things related to the end of their life is fulfilling and meaningful for both of you. 

May 22, 2023 | 5 min read

“Death is Never Neat”

By Rachel Coghlan, PhD, MPH, Center for Humanitarian Health, Bloomberg School of Public Health

There are many ways we support those journeying through illness and death. Our authentic caring often finds itself in this sometimes-messy space.

February 10, 2025 | 2 min read

The weight of words, the power of presence 

Effective care includes explicitly communicating empathy and compassion. This includes overcoming language barriers between patient and clinician by collaborating with a medical interpreter.

June 28, 2023 | 3 min read

Dad’s End-of-Life Lessons

By Eric Last, DO, Northwell Health, Wantagh, New York

As my father was dying, it became clear that he had many misconceptions. This reminded me of how important it is to explore each patient’s understanding of palliative care and hospice.

December 11, 2024 | 2 min read

Taking the call 

By Stasia Reynolds, MD, Johns Hopkins Medicine

It is a privilege to bear witness to the suffering our patients endure and to share in the joy that comes in honoring a dying wish.   

April 8, 2025 | 3 min read

“Can you help me die?” 

By Carolyn Rennels, MD, University of San Francisco

When a patient asks about medical assistance in dying, prioritize deep listening and exploration of fears and hopes over immediate procedural responses. This can help reassure them that you’ll accompany them to the end. 

October 16, 2023 | 1 min read

Clinging to Hope

By Avani Prabhakar, MBBS, MPH, Johns Hopkins Medicine, Nitin Narayan, medical student, Gujarat, India

A patient’s family wasn’t ready to accept that their loved one wouldn’t recover. From the encounter, I learned that sometimes it may be appropriate to delay such conversations for a little while. 

"A day in the life of a caregiver." Digital art by Lingsheng Li.

July 31, 2024 | <1 min read

A day in the life of a caregiver  

By Lingsheng Li, MD, MHS, University of California, San Franscisco

Family and friends caring for people with chronic illness often shoulder immense burdens without adequate support. Clinicians can help by expressing gratitude and/or acknowledging some of the challenges they face. 

November 15, 2018 | 3 min read

You’re Always a Provider, Even in the Coffee Line

By Ishwaria Subbiah, MD, MS, The University of Texas MD Anderson Cancer Center

Opportunities to ease distress extend beyond the bedside and outside of the clinic to every interaction with our patients and also their caregivers.

February 5, 2019 | 2 min read

Creating a Clear Care Map for Patients

By Chris Myers

Showing patients and their families a clear map of their care plan can help bring awareness and healing to patients and families alike.

August 4, 2020 | 2 min read

3 Tips for Talking With Patients About Advance Directives

By Ambereen Mehta, MD, Johns Hopkins Medicine

ALL clinicians can and should encourage patients to document their wishes regarding medical decisions in case they’re unable to make these decisions for themselves.

December 14, 2023 | 2 min read

Listening for meaning

By Ben Roberts, CRNP, AGACNP-BC, ACHPN, Johns Hopkins Medicine

In my palliative care career, I’ve learned that aligning care with patient goals is one of the most important parts of clinical excellence. To do this, I listen to truly understand what the patient wants. 

October 24, 2019 | 1 min read

The Art of Talking About Death

By Michelle Gyenes, MS, Columbia Mailman School of Public Health

The clinically excellent clinician engages in honest conversations about death and dying with patients and their families.

May 23, 2022 | 2 min read

Communication: A Chaplain’s-Eye View

By Peter Heikkinen, MDiv, Johns Hopkins Medicine

Hearing, acknowledging, and appreciating the patient’s perspective is central to effective communication. 

"I asked his family what he'd want us to know about him and his daughter said he loves Irish music."

February 15, 2021 | 2 min read

End-of-Life Care During The Pandemic

By Ambereen Mehta, MD, Johns Hopkins Medicine

Hospital visitation is limited during the pandemic. To alleviate the stress of this restriction, connect patients with their families via video as often as possible.

October 14, 2021 | 1 min read

Caring During Death

By Vivian Altiery De Jesus, MD, MBE, Johns Hopkins Medicine

It’s a privilege to care for patients and their loved ones, especially at the end of life. Even when we can’t cure, we can always comfort.

November 10, 2021 | 5 min read

Reading Between The Lines

We don’t always say what we’re thinking, particularly in difficult conversations. Sharing and exploring unspoken thoughts can lead to stronger connections with our patients and better care.

October 10, 2019 | 2 min read

Our Greatest Teachers

By Vivek Murthy, MD, Johns Hopkins University School of Medicine

To find meaning in your clinical work, search for the words and moments that affirm your shared humanity with patients.

April 20, 2021 | 3 min read

Listening to Every Patient

By Pringl Miller, MD, San Francisco, California

To give clinically excellent care to the patient in front of you, ask yourself: “Am I carefully listening to what the patient is telling me? Am I incorporating what I’ve heard into the care plan?”

Hippocrates featured in the interior of the old town hall in Gõttingen, Niedersachsen, Germany. Public domain, Wikimedia Commons.

February 20, 2020 | 3 min read

“Life is short, and art long”

By Jonathan Yeh, MD, Johns Hopkins University School of Medicine

The art of honest and empathetic communication is fundamental to being an excellent clinician. And, it can be improved with intentional practice.

May 9, 2023 | 3 min read

Interpreting Patients’ Goals

By Adela Wu, MD, Stanford Medicine

While caring for a patient who spoke a different language than I, the medical interpreter translated more than words. She also explained cultural differences that proved invaluable.

June 2, 2022 | 2 min read

‘68 Chevy Camaro

By Jennifer Eitingon, MD, Johns Hopkins Medicine

If we limit the way we view our patients, we will miss out on what makes them who they are. By taking time to learn more about them as people, we can connect and offer better care. 

March 2, 2022 | 1 min read

Redefining Success

By Jennifer Eitingon, MD, Johns Hopkins Medicine

My patient on palliative radiation died in the hospital, instead of at home as she wanted. I was reminded that we must always create a treatment plan based on the patient’s goals instead of our own. 

November 10, 2023 | 2 min read

Final journeys

By Elizabeth Gundersen, MD, University of Colorado

Today, we remember patients who have served our country. We are grateful for the honor and privilege of caring for these veterans through their final journeys.

October 10, 2022 | 3 min read

“What Else?”

By Matthew McEvoy, MD, Houston, Texas

Asking these simple two words and showing genuine concern can bring out a richer story and promote healing. 

Vibraphone. Copyright Chris Dingman.

December 5, 2019 | 2 min read

Peace—Music to Live

By Chris Dingman, vibraphonist and composer

Music with intention and sensitivity can be a powerful tool for helping the terminally ill—and others—cope with physical and emotional pain in order to find peace. Recommending this form of therapy to patients can be a valuable gift.

March 25, 2019 | 2 min read

Movie Review of “End Game”

By Barry Bryant, MD, Johns Hopkins Medicine

The documentary "End Game" includes honest and reflective conversations with patients about what dying might be like, and investigation into what patients want the end of their life to look like.

January 19, 2023 | 2 min read

With Only a Nod

By Becky Sansbury, MDiv, Raleigh, North Carolina

Sometimes the best care we can give is to be quiet, observant, and appreciative of our patient’s sharing a life-changing moment.

December 13, 2021 | 1 min read

Grace

By Farah Ali, DO, Johns Hopkins Medicine

Faith plays a significant role in many patients’ lives. Learning more about their beliefs can help us to understand them better and allows us to serve our patients in line with their values. 

November 18, 2021 | 3 min read

Adequate Bandwith

By Jennifer Eitingon, MD, Johns Hopkins Medicine

Recently, a patient dying of cancer requested CPR despite many clinicians advising against it. When it feels challenging to understand a patient’s decision, I remind myself to consider the situation from a different perspective.

March 2, 2023 | 2 min read

Meaningful Chords

By Ben Roberts, CRNP, AGACNP-BC, ACHPN, Johns Hopkins Medicine

When my patient’s wife brought his guitar to the hospital, I realized it’s impossible to overestimate the impact of reuniting patients with what matters most to them. Do what you can to make this happen. 

August 2, 2021 | 1 min read

How to Support Patients Facing an Upsetting Diagnosis

By Steve Kravet, MD, MBA, Johns Hopkins Community Physicians

In medicine, we often inform patients of new diagnoses that are life-altering—sometimes overwhelmingly so. At these times, we must show empathy and check-in frequently with them.

February 27, 2023 | 2 min read

Children Need Hospice Too

By Emily Johnson, MSN, RN, Johns Hopkins Medicine

Regularly reassessing goals of care is necessary during critical illness. This can help families maintain hope and realistic expectations. 

August 30, 2022 | 2 min read

Hope in The Hospital: a Lesson From “The Sandman”

By Joshua Briscoe, MD, Durham VA Health Care System

Accepting the hopes and dreams of our patients is a way to show compassionate presence.  

September 16, 2024 | 3 min read

What healthcare professionals can learn from Clover, the death doula 

By Scott Wright, MD, Johns Hopkins Medicine

A novel reminded me about best practices in caring for the dying. “The Collected Regrets of Clover” repeatedly stressed to acknowledge the emotional complexities surrounding death and to never look away from someone’s pain. 

February 17, 2020 | 1 min read

Insights From “Dying in the Neurological ICU”

By Ambereen Mehta, MD, Johns Hopkins Medicine

Excellent clinicians are aware of the level of uncertainty in which we practice and empathize with the challenge that patients and families face in the face of that uncertainty.

December 9, 2021 | 4 min read

3 Lessons From Coach Ted Lasso

By Claire Crawford, MSW, PhD, Texas Childrens , Jared Rubenstein, MD, Baylor College of Medicine, pediatric

Apple TV’s “Ted Lasso” shares a simple message—be kind. We can never truly know what it’s like to walk in another person’s shoes. Curiosity, instead of judgment, helps us give better patient care.

November 20, 2023 | 2 min read

Honoring indigenous culture amid serious illness

By Katie Nelson, PhD(c), MSN, RN, Johns Hopkins University School of Nursing

We must seek to understand the beliefs, rituals, and ceremonies of all patients and communities. Failing to honor these may erode trust.

January 7, 2021 | 4 min read

3 Steps to Develop Your Philosophy of Caring

By Aidan Crowley, Medical Student, University of Pennsylvania

Identifying the principles that guide your care of patients will bring more meaning and purpose to your work. This can bring both you and your patients joy and fulfillment.

February 24, 2022 | 3 min read

New dad and healthcare professional

By Ben Roberts, CRNP, AGACNP-BC, ACHPN, Johns Hopkins Medicine

Placing my child’s and my patients’ needs before my own gives me purpose. These responsibilities help mitigate burnout and allow me to give excellent care.

Encourage caregivers to get support.

September 8, 2021 | 2 min read

How to Mitigate Caregiver Burnout

By Simone Lescott, MD, Johns Hopkins Medicine

Caring for a loved one can be emotionally exhausting. Remind caregivers to prioritize self-care and encourage them to seek support from others.

October 21, 2020 | 3 min read

Show Me

By Jared Rubenstein, MD, Baylor College of Medicine

Asking patients to share photos and videos can give clinicians a deeper understanding of their lives. This may allow us to give better person-centered care.

"Spending time outdoors helps me cope with the stress and sadness of the job." -Dr. Jared Rubenstein

December 10, 2020 | 3 min read

Coping With Patients’ Heartbreak

By Jared Rubenstein, MD, Baylor College of Medicine

When supporting patients and their loved ones during times of great sadness and loss, cultivating a daily habit of self-care may protect against burnout.

October 19, 2021 | 2 min read

Asking About Your Patient’s Pet

By Elizabeth Steuber, MD, Johns Hopkins Medicine, Todd Brenner, MD, Johns Hopkins Medicine

Ask patients about their pets. This can build a bridge to talking about topics like functional status, home life, and family dynamics.

October 20, 2021 | 3 min read

Rethinking the Routine in the Pursuit of Inclusion

Interprofessional team members bring a rich variety of perspectives about patients that can lead to better whole person care. Using first names among our team helps minimize power differentials.

June 5, 2024 | 2 min read

Near death

By Aurora Grutman, medical student, Johns Hopkins Medicine

Overcoming anxiety about the end of life allows one to explore concerns with empathy and openness. A willingness to learn about patients’ spiritual beliefs can help clinicians provide compassionate and holistic care.

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