Our Faculty Talk About Palliative Care

Many faculty members are part of the UW Palliative Care Center of Excellence — our collaborative attempt to standardize and promote excellent palliative care practices, research and education across UW Medicine and throughout the University of Washington. Here’s what some of them have to say.

 

An epiphany during the AIDS crisis

When young men started contracting AIDS in the 1980s, Johns Hopkins — that’s where I was training at the time — became a de facto HIV center. We saw a lot of deaths back then. One of the things I took away from my time there was how different the experiences were for the patients and their extended families. In one hospital room, the death would be a peaceful process for the family and the friends who were gathered there. In the next room, with basically the same clinical team, the situation would be a complete disaster. I realized that it was possible to do these end-of-life situations well but that we often don’t, and we didn’t understand why.  Since then, a lot of my focus has been on understanding and improving end-of-life care.

Randy Curtis, M.D., Res. ’91, ’92, MPH
UW Professor of Medicine, Division of Pulmonary and Critical Care
Director, UW Palliative Care Center of Excellence
A. Bruce Montgomery-American Lung Association Endowed Chair in Pulmonary and Critical Care Medicine

 

Becoming a role model

My work in palliative care has focused on developing educational interventions that enable physicians to learn more effective ways of communicating. I want them to be able to use their time wisely, maximize patient understanding, support patient coping, and enable patients to make medical decisions that match their values.

I was drawn into this work by my own struggles in trying to figure out the best way to talk to patients who were facing serious illness, but feeling like I didn’t have good role models to follow — palliative care is a relatively young field. So I plumbed the educational literature and psychological literature to find better ways. And we’ve proven these new ways work by analyzing the conversations that expert physicians conduct.

Anthony L. Back, M.D., Res. ’87, Chief Res. ’88
UW Professor of Medicine, Division of Oncology
Co-director, UW Palliative Care Center of Excellence
Founder of Oncotalk

 

Caring for gravely ill children and families

There are important differences between pediatric palliative care and palliative care for adults. Fortunately, severe, life-limiting illness is rare in childhood, but when it occurs, it is an affront to the natural order of things, and it is always out of season.

Children present a complicated, challenging developmental spectrum. Imagine developing treatment plans for babies, preschoolers and adolescents. Their needs are all very different. Children are often more resilient than adults, and the courses of their diseases are less predictable, so it’s harder to make medical plans for them.

In addition, many communities don’t have the expertise to take care of these patients, so seriously ill children and their families may have to travel far from home for treatment. Uprooting a child and family from their community removes children from familiar emotional and spiritual sources of support. It also may disrupt parents’ employment and strain family relationships and finances. In fact, the experience of having such a sick child can lead to post-traumatic stress disorder in many families.

We are engaged in a research project that increases family support with regular care conferences and follow-up visits in the ICU. We hope that this intervention will reduce the suffering that stress adds to the family’s experience of severe pediatric illness.

 

Ross M. Hays, M.D. ’78
UW Professor, Departments of Rehabilitation Medicine, Pediatrics, and Bioethics and Humanities
Medical Director, Pediatric Palliative Consulting Service, Seattle Children’s 

 

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