Quotes from Ira Byock

she had a life-threatening illness and was too ill to speak for herself, she did not want any invasive measures to prolong her life: no surgery, no CPR, no mechanical ventilation, no artificial nutrition and hydration.

there are ways of controlling the discomfort bowel obstructions cause without surgery, but doing so would take palliative care expertise of the sort that a hospice program provides.

intentions. If our intentions are good and we are willing to ask for and offer forgiveness and express gratitude and loving feelings for another person, we usually feel better for having made the effort. Sometimes that needs to be enough. If the other person responds warmly, that's great. But, in matters of this sort, there is intrinsic value in making a good-faith effort. He said that all of this made sense and he would give it some thought.

He didn't want anyone to perform CPR because he knew that even in the unlikely event that it restarted his heart, it would just mean that he would die in an ICU.

It is morally and legally okay to show genuine concern for other people.

social connections are often as important as medical treatment in preventing physical, mental, and functional decline.

Similarly, to the family of a seriously ill person, sometimes plainly stating, "Your father is dying," can be a gift in the most difficult of times.

Anger is a way of holding sadness at bay; the emotions are two sides of the same coin. Anger is energizing. When we are angry we look out, adopt a protective posture, and get ready for action. In contrast, sadness saps our energy. When sad, we look inward, become reflective, and are aware of our vulnerability.

Too Soon to Say Goodbye, Buchwald writes about how he came to be admitted to a hospice facility in the Washington, D.C.

hospice care would be assigned to them and while they would see that nurse most frequently, hospice care entailed a team—very much like our palliative care team, which they had come to know—with a physician, chaplain, social worker, and even volunteer visitors.

discussion. It now seemed possible that team-based palliative care extended life to a degree comparable to newer immune-based chemotherapy drugs that may cost $6,000 to $10,000 per month and can cause rashes, bleeding, infection, and other life-threatening side effects. In contrast, team-based palliative care for a patient and family typically costs several hundred dollars per month and does not cause rashes, bleeding, or infections.