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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.  

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.

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. 

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.

July 23, 2024 | 3 min read

The last gaze: witnessing a peaceful death 

By Michael McCarthy, MD, Johns Hopkins Medicine

In Abraham Verghese’s novel “Cutting for Stone” I learned about how to help patients face death. This includes considering the role of spiritual support and ensuring patients feel cared for in their final moments. 

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.

January 29, 2024 | 2 min read

Life after grief 

By Jaime Jump, DO, Texas Childrens Hospital

I was invited to a baby shower for the sibling of a baby who had died in my care. Talking with the parents taught me that beyond sadness, there can be hope and joy.  

January 24, 2024 | 2 min read

Grief in the season of joy 

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

After the holidays, I think back on patients who passed in December, an especially hard time to lose a loved one. At this time of year, I make an extra effort to help loved ones process their feelings. 

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?

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. 

April 15, 2024 | 1 min read

When the end is near 

By Avani Prabhakar, MBBS, MPH, Johns Hopkins Medicine, Shubham Tomar, MBBS, MPH, Vanderbilt University Medical Center

At the end of life, loved ones often must make difficult decisions. Healthcare professionals can help ease this burden by showing empathy and compassion. 

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. 

November 8, 2023 | 2 min read

Memory is a poor monument

By David Kopacz, MD, University of Washington

Healthcare professionals often witness challenging events, like the death of a patient. Writing and other artistic expression may help us process emotions. 

"Irises," by Elizabeth “Elsie” Sophia Skorski Kopacz.

August 9, 2023 | 2 min read

To Grandmother’s House We Go

By David Kopacz, MD, University of Washington

Religion and spirituality are part of the human experience. Sometimes, it can improve patient well-being to include these topics in our conversations.

May 7, 2024 | 3 min read

“My patient is dying”

By Nakiya Showell, MD, MPH, MHS, Johns Hopkins Medicine

Excellent patient care goes beyond medical expertise. Building relationships, clear communication, and emotional intelligence are crucial for compassionate care, especially in the face of critical illness. 

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.  

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.

July 18, 2022 | 2 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. 

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.” 

March 4, 2024 | 2 min read

Getting the diagnosis right 

By Colleen Christmas, MD, Johns Hopkins Medicine

After arriving at what you think is the diagnosis, pause and consider alternative explanations. For patient populations at high risk for misdiagnosis (women and historically marginalized groups), examine how biases might be influencing your conclusions. 

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. 

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. 

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. 

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 20, 2023 | 3 min read

Unhappy holidays

By Larkin Corrigan, MSW, Portland, Oregon

During “the most wonderful time of the year,” we can remind patients, loved ones, and ourselves, that grief often sits side by side with joy at the holiday table, and that’s ok.  

November 27, 2023 | 2 min read

Immunity illusions

By Abraham Nussbaum, MD, Denver Health

When my classmate in medical school died of chronic illness, I was finally able to imagine myself as a patient. I now treat patients with the compassion that I would want to receive in the hospital.  

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.

March 18, 2025 | 1 min read

“I wish for you”

By Kathleen Wenaden, MBBS, London, England

Witnessing suffering requires clinicians to intentionally practice self-care. One idea is to process challenging emotions by writing poetry.

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.

December 15, 2021 | 1 min read

The Power of Humor

By Jennifer Eitingon, MD, Johns Hopkins Medicine

My dying patient taught me that laughter can sometimes normalize difficult situations. Finding humor in the problem lightened the mood and allowed us to devise a care plan that preserved her dignity.  

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.

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 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.

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 27, 2025 | 1 min read

“Breaking bad news”: a poem

By Miriam Colleran, MD, St. Brigids Hospice & Naas General Hospital, Ireland

I wrote this poem to explore sharing and receiving challenging news from the perspective of both clinician and patient. Reflecting on situations from multiple points of view enhances my ability to empathize.

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 9, 2024 | 2 min read

Softening the “SPIKES” 

When delivering challenging news, it is crucial to tailor the communication to the patient's preferences. Break down the message into small, spaced-out segments to allow for gradual processing. 

"Dreamscape." Painting by the author.

September 30, 2024 | <1 min read

Approaching the horizon 

By Jessica Berry, PhD, clinical psychologist

My painting, “Dreamscape,” represents the importance of acknowledging and addressing patients' feelings about aging and mortality.  

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.

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