REPLY
Regarding the Unkind Death of Billie Belle
Michael K. Williams, MD
21 August 2001 | Volume 135 Issue 4 | Page 303
IN RESPONSE:
Dr. Rousseau's concerns, published in a previous issue of Annals (1), regarding my negative portrayal of hospice care are valid. I agree that new physicians should view the performance of hospice in the episode I describe as a terrible aberration. In my own experiences, I have witnessed only the most laudable performances. Surely most practitioners who have used this invaluable service have also had overwhelmingly positive experiences. I very much doubt that their overall positive perceptions of hospice will be altered in any significant way by this particular sad episode. Nonetheless, it is my belief that we can always do better. As Dr. Rousseau points out, nonmedical offerings are important in a patient's final days. However, they will be better received and have more meaning to the dying if accompanied by appropriate doses of analgesia.
Drs. Tolle and Tilden also raise important end-of-life issues. Instructing young physicians in dealing with such delicate and difficult family decisions should have a higher priority. To debate whether this is a teachable skill is fruitless. Practitioners in a position to influence those new to our profession teach something by their own actions every day. We may as well teach properly by showing the more tactful and humane sides of our own natures when we encounter these particularly sensitive situations.
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Author and Article Information
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Brackenridge Hospital, Austin, TX 78701 (Williams)
1. Rousseau P. Billie Belle [Letter] Ann Intern Med. 2001;134:1009 [PMID: 11352706].[Free Full Text]
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