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Medical Residents Talk About End of Life Issues

When you sign up to work on my side of the sliding doors, you expect to use your knowledge and skill as a healer.  To conquer disease and pull people back from the brink.  The uplifting stuff.  But sooner or later, you discover that dealing with death is also part of the job.  Recently, we broadcast a revealing conversation with a group of extraordinary residents I met at McMaster University in Hamilton.  Many of you wrote in saying you wished you could hear more from them.  Well, we listened to you.  This Monday, December 27 only, White Coat, Black Art brings you an extended conversation with the next generation of Canada's physicians on learning how to deal with patients at the end of life.  It's on at 11:30 am (3:30 pm in parts of Newfoundland and Labrador) on CBC Radio One.

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You can read more about this episode after the jump...

These days, Canadians are thinking a great deal about end of life issues. A recent Senate report found that 70% of Canadians have no access to palliative care at the end of life.  And, a survey done for the CBC and Radio Canada found more than 8 in 10 Quebecers support the legalization of euthanasia.

People inside the corridors of medicine are also talking about end of life issues.  That includes residents - recent med school grads who are taking post-graduate training at Canada's teaching hospitals.  Andrew Burke is a second year resident in internal medicine. Clarissa Burke is a third year resident in family medicine. Rick Mann is a second year resident in family medicine.  Nooreen Popat is a third year resident in internal medicine. They're all residents at McMaster. Gaurav Puri is a second year resident at the University of Toronto. 

It's our mission on White Coat, Black Art to have doctors, nurses and other health professionals speaking candidly about what goes on inside medicine's sliding doors.  It's highly unusual to find residents as candid and reflective as the ones you're about to hear. 

Dealing with death is something you learn -- not from a book -- but by holding a patient's hand...and by talking with a worried or grieving family.  Nobody knows that better than residents.  They learn medicine at teaching hospitals by practicing on you.  Staff physicians supervise them.  But at night, it's you and a resident in the battle to cheat death.  I spoke with these five residents about those moments when they learn how to size up when the battle over life and death is likely to be lost.  And where they pick up the language we use to describe that.  I warn you, the shorthand we use to talk about the end of life is jarring and maybe a bit upsetting

In Part One of my conversation with the residents, they speak about learning at the bedside how to recognize patients who are dying -- some with shocking speed and others in a stunning reversal of fortune -- and how they need to process what they have seen and experienced.

In Part Two, they speak about learning how to tell patients they're dying.  I was struck with Dr. Nooreen Popat's comment that telling patients the end is near is both difficult and a privilege.  It's something thoughtful physicians tend to say.

If they represent the next generation of MDs, your health is in good hands.

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