Palliative Care

I shadowed a pain/palliative care doctor today. Trained in family medicine, he had an early interest in death and dying and worked for the first hospice in Sonoma County. He is now the medical director for a palliative care unit and also does private care pain management. It was interesting to see the differences in this practice. He takes very good care of his patients; the first patient was in a wheelchair and I noticed that he was particularly gentle in wheeling him through the narrow corridors. This doctor does all his histories in his office, an executive-looking room with mahogany (or some other fancy wood) furniture, oil paintings, and comfortable chairs. He only uses the stuffy exam room if he has to do a physical. His patients are all fairly complicated, with chronic pain and cancer pain, and he takes a long time with them. I'm not sure I could deal with that kind of chronicity and difficult management as a career, but it is definitely an important aspect of medicine.