Seeing the country ready to move on from #COVID is leading me to reflect on my own experience.
As a pediatrician, I know I haven’t seen nearly the devastation that my colleagues in adult medicine have.
As a pediatric palliative care doctor, I’ve seen enough.
🧵 1/7
I’ve seen children die from #COVID and, to me, one preventable child death is too many.
If you’re wondering, “Did they have underlying illnesses?” ask yourself why you’re asking that, and why it should matter
2/7
I’ve seen children who love to move and dance get blood clotting complications from #COVID and end up having limbs amputated, their lives changed forever
3/7
I’ve seen pregnant women get #COVID and go into premature labor, then care for those infants as they died as a result of that prematurity
4/7
These are the people I think about as I continue to do everything I can to avoid bringing #COVID home to my own young children
These are the people I think about as I continue to get stares for masking in public
5/7
These are the people that I wish our society would think about as it prepares to move on from #COVID
These are the people that I’ll never be able to forget
6/7
And these are the people I think about when I’m not sure how to reintegrate into a society that I now know doesn’t think about them at all.
7/7 End 🧵
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Yes, fear of palliative care comes from an association in some people’s minds with death.
As many including @SoniaMKhunkhun@anandiyermd@ctsinclair have pointed out, that is likely a failure of education and due to a cultural fear of death itself, not palliative care.
2/
When we conflate the scary thing with something that can help with the scary thing we risk missing a big opportunity for support.
As I’ve said before, it’s like confusing the fire with the fire department:
Dignity Therapy is a legacy project in which a facilitated interview is compiled into a narrative document which a dying person can share with loved ones.
A #medthread#tweetorial on assessing goals of care. People often say “tell me your goals” and are confused when the response is “get better and go home” and conversation over.
First, until patients have been given reason to consider a goal beyond this (new bad news, disease progression, etc.), there probably isn’t any reason for a person to feel the need to reasses their own goals.
Second, “goals of care” is jargon and those words may not have meaning to a patient. What you really want to know our their values, hopes, and what gives life meaning. Ask about hobbies. How is life outside the hospital? Where do they get their strength?