According to a recent Kaiser Family Foundation poll, seven in 10 Americans say they would prefer to die at home. And that’s the direction the health care system is moving, too, hoping to avoid unnecessary and expensive treatment at the end of life.
Hospice allows a patient deemed to have fewer than six months to live to change the focus of their medical care — from the goal of curing disease to a new goal of using treatments and medicines to maintain comfort and quality of life. It is a form of palliative care, which also focuses on pain management, but can be provided while a patient continues to seek a cure or receive treatments to prolong life.
To find out, I talked with Sarah Cucinella-McDaniel, chief registrar at the Denver Art Museum. She’s sort of like a travel agent for art — and for this exhibition she booked the itineraries for artworks from more than 70 lenders around the world: museums, as well as private collectors. (One of her recent days started unexpectedly, around 1:45 a.m., when one of her nine Monet shipments for the day arrived at the museum hours ahead of schedule.)
Rieder likens his experiences trying to get off prescription pain meds to a game of hot potato. “The patient is the potato,” he says. “Everybody had a reason to send me to somebody else.”
Eventually Rieder was able to wean himself off the drugs, but not before receiving bad advice and going through intense periods of withdrawal. He shares his insights as both a patient and a bioethicist in a new book, In Pain: A Bioethicist’s Personal Struggle With Opioids.
Press play button above to hear interview.
In 2015, Travis Rieder, a medical bioethicist with Johns Hopkins University’s Berman Institute of Bioethics, was involved in a motorcycle accident that crushed his left foot. In the months that followed, he underwent six different surgeries as doctors struggled first to save his foot and then to reconstruct it.
Rieder says that each surgery brought a new wave of pain, sometimes “searing and electrical,” other times “fiery and shocking.” Doctors tried to mitigate the pain by prescribing large doses of opioids, including morphine, fentanyl, Dilaudid, oxycodone and OxyContin. But when it came time to taper off the drugs, Rieder found it nearly impossible to get good advice from any of the clinicians who had treated him.