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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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May 12, 2020 | 1 min read

Jump-start End of Life Discussions With “Death Over Dinner”

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

The pandemic has created a sense of urgency around advance care planning and end of life preparations. Resources like "Death Over Dinner" can help broach conversations about death, dying, and the end of life in a non-threatening (and even entertaining) manner.

January 12, 2022 | 2 min read

The Comfort of Death Rituals

By Jennifer Eitingon, MD, Johns Hopkins Medicine

In the past, I questioned the value of certain rituals. A woman from Panama showed me how these may provide comfort to those who have lost a loved one.  

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.

August 10, 2020 | 1 min read

Debriefing After Death

By Christopher Bennett, MD, Stanford University

Reflecting on a patient's death as a team provides an opportunity to process emotions and strengthen team dynamics.

July 8, 2021 | 1 min read

Reaching Out to Your Patient’s Family When Death is Imminent

By Jeffrey Millstein, MD, Penn Medicine

When my friend died of pancreatic cancer recently, I saw how valuable it was for her family to hear from the treating physician. Going forward, I will emulate this inspiring practice.

August 11, 2022 | 2 min read

A Mother’s Death

By Avani Prabhakar, MBBS, MPH, Johns Hopkins Medicine

Including a patient’s words in your empathic response is affirming and creates connection.

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.

June 1, 2022 | 2 min read

“The Pause”

By Eileen Barrett, MD, MPH

Healthcare professionals give their best patient care when they are emotionally well. Making time to grieve the loss of a patient can help clinicians heal. 

January 20, 2022 | 2 min read

Reflecting on Boundaries During Times of Loss

By Leslie Miller, MD, Johns Hopkins Medicine

Recently, my eyes filled with tears upon learning of a death in my patient’s family. Empathizing with patients who have suffered a loss can bring up strong feelings. How much of this is ok for clinicians to reveal?

July 26, 2022 | 2 min read

Sharing One More Pint

By Avani Prabhakar, MBBS, MPH, Johns Hopkins Medicine

When caring for a cancer patient who lived days longer than expected, I learned to be humble in my prognostications and to help patients receive “extra” moments of life as gift. 

Original artwork by Dr. Nathan Gray.

June 27, 2022 | <1 min read

Dying Words Aren’t What I’d Imagined

By David Shih Wu, MD, Johns Hopkins Medicine, Nathan Gray, MD, Johns Hopkins Medicine

The things people say when time grows short still have the power to spark wonder, humor, and connection. 

July 18, 2022 | 1 min read

How to Have Effective Discussions About Alcohol 

By Beth McGinty, PhD, Johns Hopkins Medicine, Mike Fingerhood, MD, Johns Hopkins Medicine

Talking with patients about the risks of heavy alcohol consumption and the benefits of change can have a positive impact on their health. 

September 17, 2020 | 3 min read

5 Tips for Talking About Autopsy Results With Your Patient’s Family

By J. Stephen Nix, MD, Johns Hopkins Medicine

Managing loved ones’ expectations before the autopsy is critical. Ensuring there's ample time to privately review and explain the results can help bring meaning and closure to their loss.

February 22, 2018 | 3 min read

Family History and Addiction Risk

By Margaret Chisolm, MD, Johns Hopkins Medicine

For some patients the risk of becoming addicted to prescription opioids is extraordinarily high and may outweigh any pain control benefit.

March 30, 2022 | 3 min read

Mitigating Maternal Mortality

By Kimberly Turner, MD, Johns Hopkins Community Physicians

A more diverse clinical workforce brings greater variety of perspectives in patient care which may improve clinical outcomes. 

December 20, 2021 | 1 min read

What Patients With Serious Illness Want to Know Most

By Avani Prabhakar, MBBS, MPH, Johns Hopkins Medicine

After receiving a terminal diagnosis, many patients especially want to know how long they have to live, what symptoms to expect, and how to cope with impending decline.  

March 4, 2021 | 2 min read

Clear is Compassionate

By Jillian Bybee, Michigan State University

Always be honest and transparent when talking with patients, even when sharing bad news.

August 21, 2018 | 1 min read

Talking With Young Adult Patients About Alcohol

By Mike Fingerhood, MD, Johns Hopkins Medicine

Clinicians need to be vigilant to discuss alcohol use with patients and remember that the legal drug, alcohol, causes more morbidity and mortality than opioids.

December 21, 2022 | 1 min read

The “D” Word

By Delia Chiaramonte, MD, MS, Integrative Palliative Institute

To give excellent care to patients we must become comfortable using direct language, including words like “death” and “dying.” 

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.

May 10, 2021 | 2 min read

Bearing Witness

By Jennifer Caputo-Seidler, MD, University of South Florida

During the pandemic healthcare professionals have often been the only ones present with patients at the end of life. It’s ok if you struggle to find the right words—sitting with a patient so they're not alone is enough.

March 18, 2021 | 5 min read

The 24 Notes of Taps

By William Wright, DO, MPH, Johns Hopkins Medicine

Let us honor the bravery of clinicians who have sacrificed everything in this pandemic to serve others.

March 24, 2021 | 3 min read

Life, Death, and Taxes

By William Hornberger, CPA, JD, Dallas, Texas

As a patient who’s a lawyer, I’ve learned that lawyers and doctors have more in common than you might think. Finding a professional who is humble, kind, and trustworthy can make all the difference in your experience with law and medicine.

May 25, 2022 | 2 min read

Between The Lines

By Avani Prabhakar, MBBS, MPH, Johns Hopkins Medicine

Sometimes patient questions aren’t something to answer quickly. Instead, they can create a space to explore underlying concerns. 

November 11, 2021 | 3 min read

Dying Alone

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

Caring for a patient dying of AIDS reminded me that—while it's necessary to be fully present and listen attentively to all patients—those who are alone need even more of our time. 

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.  

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.

November 2, 2021 | 2 min read

What All Clinicians Must Know About End-of-Life Care

By Pringl Miller, MD, San Francisco, California

Initiating and withdrawing life-sustaining medical treatment is the patient’s or their surrogate's decision, not ours. We must always honor their wishes.

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 11, 2021 | 2 min read

Helping Patients Share Disappointing Diagnoses With Loved Ones

By Ambereen Mehta, MD, Johns Hopkins Medicine, Michelle McWhirter, LCSW-C, Johns Hopkins Medicine

Patients often want to share significant health news with loved ones. You can help them choose when and how to disclose this information.

September 30, 2021 | 1 min read

The Cancer is Back

By Anonymous Physician, Johns Hopkins Medicine

I recently lost a young patient to cancer. I was reminded that even when we cannot cure our patient’s illness, we can always show empathy and compassion.

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.

July 15, 2021 | 1 min read

Honoring Patients’ and Families’ Goals of Care

By Shireen Heidari, MD, Stanford University

When supporting critically ill or dying patients, keep their care goals at the forefront of conversations and planning.

"If I die, tell my mother I love her. If I get better, I'm going to visit her in Tennessee. She has ten acres and a farmhouse."

May 11, 2021 | 1 min read

Empathy at The End of Life

By Avani Prabhakar, MBBS, MPH, Johns Hopkins Medicine

At the end of life, clinicians who are present and listen compassionately may be entrusted with patients’ final wishes. Attempting to honor these requests is one way to serve.

May 5, 2021 | 2 min read

Empathy Instead of Judgment

By Isaiah Crum, MD, University of Pittsburgh

Through the death of an infant patient, I was reminded of how integral being compassionate and non-judgmental is to clinical care.

April 22, 2021 | 2 min read

Making Condolence Calls

By Maria Carney, MD, Northwell Health, New York

When a patient dies, reaching out to the family can help them with closure. It may also be beneficial for clinicians.

"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.

February 23, 2021 | 3 min read

Tips For Giving Medical Updates to Families

By Joshua Budhu, MD, Mass General

A physician’s disappointment in hearing surprises about his loved one’s condition sparked new insights on the value of regularly updating families about the patient.

March 22, 2022 | 1 min read

Navigating my First Patient Death

By Elissa Abou Khalil, MD, University of Pittsburgh Medical Center

Acknowledging feelings and asking for support may help when dealing with loss.  

November 7, 2022 | 2 min read

Suggestions For Coping With Grief

By Justin Jeffers, MD, MEHP, Johns Hopkins Medicine

When you or others are grieving, give permission to be vulnerable and accept help. It may sometimes be helpful to work with a therapist. 

September 28, 2022 | 1 min read

The Fist Bump

By Avani Prabhakar, MBBS, MPH, Johns Hopkins Medicine

My patient and her family showed me how to celebrate and enjoy each moment, even in the face of a terminal diagnosis. 

September 27, 2022 | 2 min read

When?

By Shreya Srivastava, medical student, Albany Medical College

When my friend was struggling with her mother’s new diagnosis, she listened to the popular French song about cancer entitled, “Quand c’est?” It gave her a sense of support, empathy, and solidarity with others.

September 6, 2022 | 3 min read

Photographs at The Bedside

By Charlotte Grinberg, MD, Tufts Medicine Care at Home

Asking to see videos and memorabilia from a patient’s past may help us connect with each person in a more personal and complete way. 

September 16, 2020 | 1 min read

Music For Stress Reduction

By Chris Dingman, Vibraphonist and Composer

Spend time each day doing something you enjoy, like listening to music. Just a few minutes can help you remain balanced, avoid burnout, and give better care to patients.

August 15, 2022 | 2 min read

Role Modeling Vulnerability

By Daniel Saddawi-Konefka, MD, MBA, Massachusetts General Hospital

When a patient dies, sharing your emotions with trainees normalizes this response and highlights our shared humanity.  

March 2, 2023 | 2 min read

Meaningful Chords

By Ben Roberts, NP, 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. 

June 21, 2022 | 2 min read

“Can’t you put him down?”

By Ivor Berkowitz, MBBCh, MBA, Johns Hopkins Medicine

Medical decision making for critically ill patients is complicated and difficult for everyone involved. It is our responsibility to ensure that patients and families are adequately informed to make choices that align with their values.   

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. 

April 27, 2022 | 2 min read

Listening to Your Patient’s Grief

By Avani Prabhakar, MBBS, MPH, Johns Hopkins Medicine

By listening to a patient’s story of loss, we bear witness and affirm their experience. 

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