Here are some more letters and emails from readers regarding my story on palliative care  http://www.philly.com/inquirer/front_page/85751957.html  in Sunday's Feb. 28, 2010 paper:

 This is my blackberry so I can't type a long email.  I wanted to let you know both the long and short articles were 2 of the best articles I. Have read in years out of the Inquirer.  Being that healthcare is such an enormous issue this was written at a perfect time

Gregory Dries
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 Dear Michael, My name is Kathy Hunter, and I'm technologically challenged, so if you get this it will be a miracle. I identified with Mary's family so much. My father was a patient at Abington Hospital many times. He had multiple health problems, and was on dialysis. When the drs. came in to tell him that he needed to have his foot amputated, that was the last straw for him. They also wanted to do a femoral bypass operation to help his circulation. I was living in Wisconsin at the time with my husband and two sons. I flew to Phila., and requested a family meeting with his drs. and the nurse manager and our family. I was ahead of my time as it was in 1994. Having been an R.N. for 24 yrs at that time, I had seen my share of patients being kept alive by artificial means, and I don't agree with it. The drs tend to not tell the pt. what they are really going to face with these surgeries and treatments to keep them alive. When I made the drs tell him, he decided to stop his dialysis. When I told him that he could die a peaceful death with all of us there with him, he was so relieved. He was afraid of the awful smothering feeling he got with congestive heart failure, and didn't want to go through that. When I told him that he could go on a Morphine drip, and that takes away that fear, and he would gradually drift into a coma and die peacefully, he was so grateful. So, he died three days after stopping dialysis, and we were all with him. Everyone at Abington was so nice and helpful. Thank you for making the public aware of palliative care. Sincerely, Kathy

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Hi Mike:

Thanks for the good article ...and the courage to take on this "third rail" life and death issue. This is important work that you are doing. As difficult as it is, people should be encouraged to reflect on their beliefs and wishes regarding end of life, and make them know to their loved ones. In my view, they should have a health care power of attorney and a living will in place and readily at hand. They should discuss it with their loved ones, and with their primary care physician. In the end, it comes down to personal beliefs and wishes...and what the person in the bed wants...or would want in the decision-makers best judgment. It also, given the cost of medical care...especially for those not eligible for medicare...comes down to tough decisions about money as crude as that sounds to some people, and the quality of life that family caregivers will have. None of the decisions are easy...but it is better to start thinking of them before a crisis, then during.

Thanks again for your thought provoking article.

Have a great day.

Bill
New Hope, PA
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Hello. My name is Elizabeth Gibson. I am now a healthy 52 years old and had suffered End Stage Liver Disease and in 2007 I was in Abington Hospital.

I am very touched by your article about Mary Tole and her family's drive to never give up as far as Mary is concerned. When I sat down and started reading this come Sunday morning, I had to put it down. Memories started flowing, sad ones. I cried.

I was extremely ill. My disease had progressed to the point that the only thing that saved my life was a Liver Transplant. This I received at the Hospital of the University of Pa. in July of 2008.

While I was in Abington Hospital I too experienced their Palliative Care. I remember all to well the group of them. When they entered my room I remembered looking at the group and saw Death on their faces. I can't explain this feeling but it was there.

The Pallative Care team surrounded my bed. I felt outnumbered. As they looked down on me in my bed I felt extremely powerless. I felt like I was being ganged up on. They came a few times. Each time explaining to me how there was this place I could go to, where people were so nice and caring and that they would help me. At this point the word "help" sounded like a cure. Their soft, gentle voices were guiding me to my death. To go into hospice-a place to die. No one actually said those words to me. We are going to give up on you-you're too sick, and put you someplace where you will die. This place they were talking about seemed like heaven to me, and by being placed there I was going to get better.

I finally realized what they were trying to do. Talk me into a place where I was not ready to go. Yes I was weak, couldn't walk, had bouts of encephalopathy, experienced a coma, but my will to live was still there. I knew deep down that I wanted to fight this. I had HOPE. I told them NO-and in my next sentence asked for an exercise bike be brought to my room as I wanted to get on it and make my legs stronger so I could walk again. My will to live was stronger that that whole intimating group and all the power they thought they had. I left Abington Hospital to go into a nursing home rehab to learn to walk again. I did just that. I was placed on the waiting list through the Hospital of the University of Pa. in  February of 2008 and in July of 2008 I received The Gift of Life, a life saving liver transplant at this wonderful Hospital. I am feeling so strong again and am so thankful for this gift. My story is that of miracles. I am a miracle and miracles do happen. My heart goes out to Beth Anne and her family. I am so happy they didn't give up as far as Mary is concerned. I will be more that happy to contribute in any way. Your article touched me in so many ways. Thank you.

Elizabeth Gibson

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Dear Mike,

I'm just reading the first story in your healthcare series. Bravo to you for explaining palliative care. Our family has been through two significant medical events (one ongoing and chronic) and one abrupt and life-changing. If talking to you about either of them can help you educate your readers about the health care system and the politics and emotions of healthcare, we'd be glad to do so.

In September, my mother was diagnosed was State IV metastatic lung cancer. A non smoker and active, energetic person (you can read Sally Downey's obituary for her the week of November 10th), it was shock to all of us. In the course of a few days, our life turned upside down, particularly the life of our father, who has Parkinson's. She was his primary caregiver in the home they'd shared since we were children. My mother died six very short weeks later, after the cancer ravaged her entire body. My sister and I basically took a hiatus from our lives to care for her, as she was in and out of the hospital four times. We finally brought her home to hospice on a Thursday and she died on Tuesday. I am still in shock, and feel lucky to have access to the services of the Wissahickon Hospital to help us heal, as well as a supportive community and strong family.

Compound the shock of my mother's sudden illness and death with the ongoing care for my son, who has Tourette Syndrome, and I believe I am what they'd call a club sandwich. However, one thing we learned going through my mother's illness was how wonderful Medicare is. Through my son, I've become a strong supporter of Medicaid. Due to his disability, he is entitled to Medicaid. That means I no longer have $1000 pharmacy bills regularly. He has the help at school he needs. We have a therapist who comes to our home to work with our entire family, and much more.

When I hear people scoff at a public plan for health insurance, I realize they have probably either never experienced one, or never dealt with catastrophic illness or disability. When I compare how difficult it was to get coverage for Adam's treatment with my private insurance plan (Aetna, then Personal Choice), there is no comparison.

Again, thank you for writing about difficult issues in healthcare. If I can help in any way, please let me know.

Warmly,

Rachel Ezekiel-Fishbein

My stories on the palliative care team at Abington Memorial Hospital ran in the newspaper on Sunday. Here are the links:

Here's another press release I just received:

Here's another press release I just received:

Here's an email I just received:

 We are co-hosting a Casino Night at the Cherry Hill Health & Racquet Club
on Saturday, April 25th.  The event will provide much needed funding to
allow A Step Toward Hope, our 501C3 charity, to provide quality of life
grants to people living with paralysis.  There are many folks that really
need our help.  It is only $25 per person for tickets purchased in
advance. It’s not a lot of money, but I assure you that what we do for
others is big.  We really need your help with attendance at this event.
It will definitely be a fun evening with food, drinks, live music and real
casino style games.

More information is available on the Step Toward Hope website at
http://www.asteptowardhope.org/events.asp.

If you are unable to attend but would still like to help provide quality
of life grants for people with paralysis, you can make a donation through
our website:  http://www.asteptowardhope.org.

Thanks very much for your support!

Sincerely,
Chris Miles
CEO
Miles Technologies
800-496-8001
www.milestechnologies.com
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Here's an email I just received from the Vegan community about two upcoming lectures.

I have a story running this week about my trip to Boston, and filling you in about the Massachusetts health reform plan. People up there are very proud of what they've done, but they certainly have their work cut out for them. Read all about it this week in the Inquirer. can't say which day yet.

Seems the big battle shaping up in the Obama health reform is whether to have a public plan to compete with private insurers and what that will look like. 

Families USA just reported 27 percent uninusred in Pennsylvania at some point in the last two years. Waiting list for adultbasic in Pennsylvania is now over 200,000 people.

I was moderator on a panel the other day at the College of Physicians. a report to follow soon.