5 Questions for Ira Byock

April, 2015

By Sam Mowe

This is the third in a series of short interviews on end-of-life care that I’m conducting for Spirituality & Health. This week I’m speaking with Ira Byock, MD, a leading palliative care physician, author, and public advocate for improving care through the end of life. Byock is Professor of Medicine at the Geisel School of Medicine at Dartmouth. His latest book is The Best Care Possible: A Physician's Quest to Transform Care Through the End of Life. —Sam Mowe

What’s it like to be the doctor of a patient who is going through the dying process?
Well, it’s a lot like doctoring a patient who is living. Dying is a part of living. The threshold from living to dying is a mirage. If it’s far enough in the distance you can sort of identify when dying begins to happen. But when you get close, it’s just a continuum of living.

People often have treatment goals for themselves that are, from my perspective, unrealistic or otherwise really not in their best interest. But one of the things that I live by is the notion that this is not about me. This is about them and I’m there to give them the best care I can. So I can lay things out in front of patients and families and try to help them make decisions that use the best of medical science consistent with their values, preferences, and priorities. We offer to help them through any treatment, walking each step with them. But, at the end of the day, it’s their life, not mine. I’m just here to serve. Palliative care teams are just here to serve. It’s not about us.

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