The Last Chapter of Life

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SACRAMENTO--"To be kept clean." "Not being connected to machines." Gary Lee, MD, of the Santa Clara Valley Medical Center (SCVMC) pulls up sayings from his stack of “Go Wish” cards. Unlike cards in children’s “Go Fish” game, the “Go Wish” cards help very ill or dying patients at the center’s Palliative Care Unit talk more openly about their condition and how they wish to spend this critical period of their lives.

The palliative care team that Lee heads at SCVMC in San Jose, Calif., faces terminal illness 10 times per day. The patients they comfort may be elders, who have reached their twilight days, but also the very young people who are suddenly looking death in the eye. Patients may arrive in the SCVMC Palliative Care Clinic due to a wide range of reasons -- a car accident, AIDS or perhaps cancer.

"The Last Chapter of Life,” Nadya Ivanova’s Russian-language article for Diaspora newspaper, shows that patients able to receive palliative care find they have the right to close the final chapter of their life with dignity, without pain and with the knowledge that their dying wishes are heard and met. The article describes how a palliative care program works and explains important new develops to help patients express their wishes before they become too ill to speak for themselves.

For example, the Physician Orders for Life Sustaining Treatment (POLST) is designed to ensure that seriously ill patients can choose the treatments they want and be assured that their wishes will be honored by medical providers.

At SCVMC, Lee’s team members deal out the “Go Wish” cards to elicit thoughts and desires from states on the face of each card. “Listening to gospel music.” “Playing golf.” "To be free from pain." "To have my family with me.” "To have my funeral arrangements made." "To say goodbye to important people in my life."

Nadya Ivanova wrote this article through a New America Media Palliative Care Fellowship sponsored by the California Health Care Foundation.