Word: paines
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...without the physical demands of agony. They listened to jazz; she offered spiritual guidance; they continued to decorate their East Harlem apartment with mosaics. "The quality of my life definitely improved," Cummins said, "and that goes hand in hand with prolonging it." Even his oncologist enthusiastically welcomed Shaiova's pain treatment. "He's happy about it," Cummins said. "He's a great doctor, but he's just not trained in pain management...
Most aren't. Medical schools have only just begun to introduce curriculums in managing pain and other symptoms of the dying. The subjects are difficult to teach because most professors don't know the material, and most textbooks say little about end-of-life care. It wasn't until 1997 that the American Medical Association began developing a continuing-education packet for doctors on the subject. The group that accredits hospitals began requiring them to implement pain-management plans only this year. "In the past few years, we have seen a sea change of improvements in the issue," says Foley...
...Managing pain better would allow patients more comfortable deaths, but it can't guarantee easier ones. "When it comes to dying, pain comes in many flavors," says Robert Wrenn, who recently retired after 24 years of teaching about the psychology of dying at the University of Arizona. "Spiritual pain, social pain, even the unfinished-business pain that asks, 'Why am I here?'" Only the creepy would say dying should be cause to rejoice, and only the idealistic would say the health-care system could change our attitudes about it. But Byock, author of Dying Well, notes that dying's place...
...dying that emphasizes comfort over cure. Hospice patients must forgo further curative and life-prolonging treatments, which means they usually leave the hospital. (A hospice can be a separate place, but usually the word refers to home care.) Doctors, social workers, art therapists and others manage physical pain and help patients navigate the emotional terrain of dying...
...hope for a miracle. Recently, Cummins, the jazz producer, heard that he could qualify for a clinical trial. He knew the trial carried only a remote possibility of a cure, but he didn't want to give up. Even so, when he and Nancy totaled the cost of his pain medications--$2,250 a month--they were presented with a cruel choice: opt for hospice to save money, or go for the trial and keep paying for the drugs themselves (the Medicare hospice reimbursement includes prescriptions; Medicare generally doesn't). "So it's hospice vs. bankruptcy," said Cummins...