I have been very lucky to have found my way to palliative care. As a physician, I feel I have finally found my home in medicine. I am indebted to many individuals who have helped me along the way. To all my teachers, inside and outside of medicine, I offer my gratitude for your patient and kind instruction. To mentors and friends, especially David Weissman, Charles von Gunten, Ira Byock, and Joanne Lynn, and Brad Stuart, thank you for your guidance and role modeling. To the students, residents, and fellows who have crossed my path, it has been a great privilege to work with you. There is no greater joy for a teacher than to see students blossom, becoming teachers in their own right. A special thanks to ex-fellows and good friends Richard Meyers, who helped me in the development of the section on bowel obstruction, and V. J. Periyakoil, who helped in the development of the section on psychosocial issues. To the staff of the Stanford Faculty Development Center [http://sfdc.stanford.edu], especially Kelley Skeff, Georgette Stratos, Sara Katz, and Jane Mount, thank you for your help in developing our end-of-life care faculty development course. This manual would not otherwise have come into being. I am also indebted to the Robert Wood Johnson Foundation, which in addition to funding the SFDC project, has done so much to further the development of palliative care. Sara Katz, V. J. Periyakoil, Monique Kuo, and Maria Dans are to be thanked for their thoughtful comments and editing of this manuscript. Thank you to Vickii Ellis, Dwight Wilson, and Mark Graeber for having the foresight to develop the VA Hospice Care Center back in 1979. The hospice you developed is an enduring legacy. I was very fortunate to have been introduced to hospice and palliative care there. My gratitude to the staff and especially the patients and families of the VA Hospice Care Center at the VA Palo Alto Health Care System-on a day-to-day basis you serve as my teachers. Philosophy is grounded in practice, and practice is grounded in community. To have such a wonderful community within which to work is an honor. I am fortunate indeed.
A special thanks to my family, Toriko, Cody, and Mika, for their support. They have had to put up with much over the years. Most especially I must thank my daughter, Mika. She has never said a single word, but she has been my greatest teacher. When I tend to float off in abstract, philosophical fantasies, she brings me down to earth, reminding me that we are all here, together, in the same soup. We are here for each other.
The information in this book is not medical advice. Health care providers should exercise their own clinical judgment when providing medical care. Some of the information in this manual cites the use of products in dosages for indications in a manner other than that recommended in the product labeling. Accordingly, the official prescribing information should be consulted prior to using any such product. The author is an employee of the Department of Veterans Affairs. This work was written independent of such employment and in no way represents the views or opinions of the Department of Veterans Affairs.
Palliative Care Perspectives
James L. Hallenbeck, M.D.
Copyright © 2003 by Oxford University Press, Inc.
The online version of this book is used with permission of the publisher and author on web sites affiliated with the Inter-Institutional Collaborating Network on End-of-life Care (IICN), sponsored by Growth House, Inc.