The Heart in Hospice Care and Palliative Medicine

Rusty Hammer thought hospice care and palliative medicine was considered a last resort and accepting it meant giving up, but he found that, in many cases, the treatment can be worse than the disease.


| March 2014



Nurse does transfusion in hospital room

Rusty wrote about his cancer experience in and out of hospice care. He described chemotherapy, acknowledging, “We were most naive about the side effects and risks of treatment at the various stages.” He railed at hospital doctors who just prescribed painkillers and left the room, with never a palliative care consult or a referral to a pain specialist. “I am a living example that, in many cases, the treatment can be worse than the disease.”

Photo by Fotolia/Tyler Olson

There's a quiet, irreversible transformation happening in the way we die. Hospice was once viewed with suspicion as a New Age indulgence or fringe religious practice, but now nearly half of all Americans now die in hospice care, often at home. In Changing the Way We Die, (Viva Editions, 2013) Fran Smith and Sheila Himmel share real-world stories of patients, caregivers, researchers and the coporate giants that own the market in the first book to take a sweeping look at the landscape of hospice care. They also discuss the remarkable shift in attitudes and practices around dying, given that 97 percent of Americans say that they want to be better informed about end-of-life care. The following excerpt is from Chapter 1, "What Do You Want to Do With the Rest of Your Life?" and brings to light the positive possibilities of hospice care and palliative medicine.

What Do You Want to Do With the Rest of Your Life?

“Oh no, he’s giving up. He’s just going to die.”

All Along, doctors differed on Rusty Hammer’s prognosis. One told his wife, Pamela, “If he lasts five years, he’ll be lucky.” Another kept reassuring Rusty, “You never know. You’re doing fine. Just get more rest.”

He did last five years, but Pamela will always wonder whether the treatment was worth the torment.

Rusty was diagnosed with acute myelogenous leukemia, a rare and aggressive blood cancer. By the time he died, on Monday, January 28, 2008, he had taken more than 250 medications, received more than 350 blood transfusions, had a stem cell transplant, and spent nearly 600 nights in six different hospitals. He developed severe diabetes and osteoporosis, heart and lung failure. He needed an oxygen tank for breathing and a shunt in his brain to relieve the pain. Visiting the doctor took all day, with the wheelchair, the drive, managing a hospital bed on the other end. It left them both exhausted, and hopeless that their family’s suffering would ever end.

But hospice care brought them comfort and calm. In the last six months of his life, Rusty enjoyed the company of family and friends. He explored his religious heritage. He wrote a book, and in a strange way he also became the author of his own experience—a person again, not a medical record number or an object to be handed from one specialist to another for yet another debilitating treatment. The hospice team listened to him. Pamela found herself becoming a better listener too.