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Revisiting the art in the science of medicine

Professor Paul Lauritzen has composed a compelling piece about end-of-life care. In it, the author recounts the story of his wife Lisa dying in hospice. One excerpt in particular stands out - where the attending physician explains how patients often premeditate their own death:

“Medically,” Dr. D said, “Lisa is much better. Her vital signs are strong, and she is not experiencing any nausea. This is the good news. The bad news,” he continued, “is that your wife called the nurses in the middle of the night to say that she saw her parents on a boat outside the window beckoning her to come. I know this may not make sense,” he went on, “but we see this repeatedly in our patients. When patients report a vision like this, they almost always die within a day or two. I’m so sorry.” Lisa died just over 24 hours later. As her husband recounted, “In my wife’s last days, it was not blood work or vital signs that foretold her death, it was a dream.” These "visions" are, apparently, routine for hospice caregivers. In fact, they even have a formal name: “end-of-life dreams and visions” (ELDVs). One expert has spent ten years conducting formal research on the occurrence and impact of these dreams and visions, and has documented that they are indeed predictive of imminent death. Unfortunately, this research has not been well received in the medical community. Perhaps medicine needs to return to its roots by remembering that patient care requires both art and science. If you're interested in such an approach, I encourage you to check out The Journey's End.

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