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Virtually Speaking

Dan Kusnetzky, Paula Rooney and Ken Hess

Commenting on NY Times End of Life Article

By | August 24, 2010, 3:43am PDT

This post is about as off topic as a post can be.  If you came here wanting to read something about system software, virtualization or cloud computing, it is likely that you should ignore this post.

Still here?  Okay. The NY Times published an article that touched on some very important issues in my world (see Frank Talk About Care at Life’s End to read the article.) I found that care is all over the map when it comes to those facing end of life issues. In the end, we as a society need to reconsider how we treat those who only have a short time left.

Nearly all of the pain specialists who treated my wife during her last days would be too timid to give her enough pain medicine so that she could actually be comfortable. In more than one case, they made it extremely difficult to get prescriptions or refills.

In one case, we ran out of a medicine because I couldn’t get the Doctor to give the prescription. The pain specialist told me that “I only write prescriptions on Wednesday ” when an important medicine was about to run out. I had to go on a business trip, would only be in town to fill the prescription on Monday. The Doctor wouldn’t cooperate. I had to go and she ran out this medicine and was in extreme pain the last day of my trip. We were fortunate that we had something that acted as a partial substitute. This was the same Doctor who allowed her pain pump to run out of morphine and then wanted to wait several days for an appointment to have it refilled..

Due to this type of “care” my wife constantly told me that her pain level was a six out a scale of one to ten when a one out of ten was considered appropriate. She handled the situation with more grace and strength. I would have been ranting and raving.

Only the folks at hospice seemed to understand that long-term effects were irrelevant to someone who had no long term (thanks again Tidewell Hospice.) They understood that minutes are important to people experiencing extreme levels of pain.

The oncologist (thanks Florida Cancer Specialists) seemed to really understand that there is a point at which aggressive cancer treatment only makes things worse. He was able to frankly discuss the situation and offer different approaches allowing the customer (note I didn’t say patient) to choose.

The hospitals in our city were both, how do I say it, “less than optimal” in their approach to pain management and end-of-life care. Neither had the staff nor the capability to deal with severe cancer-related pain. One of the two did its best to include family and care-givers in the process of care. The other made it very difficult for family and care-givers to be part of “their process.” Unfortunately, we often had to deal with the second hospital because one of her Doctors was only affiliated with the second hospital.

I met those who were well on their way to earning their angel wings and others who appeared to be trying to earn other implements.

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Daniel Kusnetzky is a distinguished analyst and the founder of the Kusnetzky Group LLC.

Disclosure

Dan Kusnetzky

The Kusnetzky Group LLC is an independent technology industry research firm that focuses on system software, virtualization and cloud computing technology.

Dan's opinions are based upon research, personal experiences and actual use of technology. They are not based upon the relationships the company may or may not have with suppliers, end user organizations, the media, consultants or other analysts.

Dan's research is available on a subscription basis through the Kusnetzky Group LLC. Dan's attendance at industry events or at client meetings may be sponsored by the client. Clients may provide hardware or software for testing prior to the publication of analysis that includes that product. Clients may also provide shirts, jackets, coffee cups, folders, backpacks, pens and other event chotchkies. While nice, these don't effect Dan's opinions or insight about those clients or their products.

Biography

Dan Kusnetzky

Daniel Kusnetzky, Analyst and Founder of Kusnetzky Group LLC, is responsible for research, publications, and operations. Mr. Kusnetzky has been involved with information technology since the late 1970s. Mr. Kusnetzky has been responsible for research operations at the 451 Group; corporate and marketing strategy for Open-Xchange; system software and virtualization research at IDC; and program and product management at Digital Equipment Corporation.; Today, Mr. Kusnetzky focuses on system software, virtualization technology and cloud computing.

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RE: Commenting on NY Times End of Life Article
tariq456 18th Oct
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Surely that pain specialist deserves a few choice words and by someone from within the organization.

Maybe more that a few words would be required to get them to understand that they have the power to diminish human suffering if only they can see the light.

Shawn
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There should be no such roadblocks with dispensing adequate pain relief medication, even morphine based ones.

All medical practitioners are duty bound to provide comfort for those afflicted with disease and pain, and to save lives through whatever means are at their disposal. Toward that end, the prolongation of life against overwhelming odds enters into one of those gray, murky, often contentious zones. The best care providers, however, know where to draw the line. Such approaches should never be done by rote, that goes without saying.

As for your wife's unnecessary suffering, that is not good. Don't hesitate to make some noise, and push it upwards, if necessary DK.
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RE: Commenting on NY Times End of Life Article
Spatha Updated - 25th Aug 2010
Thanks for writing this. It's important, and something many of us will need to face up to. I saw some of the issues you describe when my brother was dying. Like you, I found the non-hospital staff* very kind and understanding.

*when the hospital, and associated insurance plans, could no longer treat him, some kind person suggested a medical rehabilitation home. It offered a means for insurance-provided treatment, at least for some additional time period. But more than that, it offered pain management and the comfort of good people. How many people don't have the luck to find such options?

There must be a better way.
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Contributr
@Spatha Hospice was a wonderful option for my wife. They treated her with kindness, professionalism and seemed to understand pain management for those facing end of life.
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