That Good Night: Life and Medicine in the Eleventh Hour

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That Good Night
That Good Night, Life and Medicine in the Eleventh Hour Book Cover.jpg
First edition (US)
AuthorSunita Puri
LanguageEnglish
GenreAutobiography
PublishedMarch 5, 2019
Publisher Viking Press (US)
Constable (UK)
Publication placeUnited States
Pages320
ISBN 9780735223325

That Good Night: Life and Medicine in the Eleventh Hour is a 2019 memoir written by Sunita Puri, a palliative care physician who chronicles her experiences with helping terminally-ill patients and their family members make end-of-life decisions. [1] She further explores the dichotomy between modern medicine and palliative care. [2] Throughout the span of 13 chapters, Puri recounts clinical encounters involving both patients and professional colleagues, stories of her upbringing, and personal reflections about the field of palliative medicine. [3] The book was published by Penguin Random House in 2019. [4]

Contents

Synopsis

That Good Night: Life and Medicine in the Eleventh Hour consists of 13 chapters divided into three parts titled Between Two Dark Skies, The Unlearning, and Infinity in a Seashell, respectively. Puri begins the memoir by recounting her time at the University of California San Francisco School of Medicine palliative care unit where she was completing her last few months of medical school. Part 1 of the memoir culminates with Puri being accepted into a fellowship program in palliative and hospice care at Stanford University while she finishes her last few months of residency in internal medicine at the University of California San Francisco School of Medicine. In Part 2, Puri transitions into her role as a fellow, which begins officially on July 1, 2013. In Part 3, Puri recounts her first job as an attending physician where she sees hospitalized patients in the morning before conducting patient home visits during the afternoon. [5]

Background

Puri is the daughter of two immigrants. [2]

Puri's mother, an anesthesiologist, inspired Puri to complete her medical school training and internal medicine residency at the University of California San Francisco School of Medicine, where Puri's interests naturally gravitated towards palliative medicine and hospice care. Thus, Puri's personal outlook on mortality, coupled with her experiences in helping and talking to terminally-ill patients during her years in medical school, residency, and fellowship at Stanford University, ultimately drove her to write the memoir. [5] [3] During the development of the book, Puri consulted with professional colleagues, patients, and the family members of patients in order to properly recount yet preserve the identities of the individuals in her stories. [4] While writing her memoir, Puri hoped that the situations described in the memoir might help others patients and families feel less alone in their navigations of mortality and end-of-life decisions. [5] [3]

As of 2019, Puri is medical director of USC's Palliative Medicine and Supportive Care Service at the Keck Hospital and Norris Cancer Center. [6]

Related Research Articles

Palliative care is an interdisciplinary medical caregiving approach aimed at optimizing quality of life and mitigating suffering among people with serious, complex, and often terminal illnesses. Within the published literature, many definitions of palliative care exist. The World Health Organization (WHO) describes palliative care as "an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain, illnesses including other problems whether physical, psychosocial, and spiritual". In the past, palliative care was a disease specific approach, but today the WHO takes a broader patient-centered approach that suggests that the principles of palliative care should be applied as early as possible to any chronic and ultimately fatal illness. This shift was important because if a disease-oriented approach is followed, the needs and preferences of the patient are not fully met and aspects of care, such as pain, quality of life, and social support, as well as spiritual and emotional needs, fail to be addressed. Rather, a patient-centered model prioritizes relief of suffering and tailors care to increase the quality of life for terminally ill patients.

<span class="mw-page-title-main">Thanatology</span> Scientific study of death and its aspects

Thanatology is the scientific study of death and the losses brought about as a result. It investigates the mechanisms and forensic aspects of death, such as bodily changes that accompany death and the postmortem period, as well as wider psychological and social aspects related to death. It is primarily an interdisciplinary study offered as a course of study at numerous colleges and universities.

In medicine, specifically in end-of-life care, palliative sedation is the palliative practice of relieving distress in a terminally ill person in the last hours or days of a dying person's life, usually by means of a continuous intravenous or subcutaneous infusion of a sedative drug, or by means of a specialized catheter designed to provide comfortable and discreet administration of ongoing medications via the rectal route.

Terminal illness or end-stage disease is a disease that cannot be cured or adequately treated and is expected to result in the death of the patient. This term is more commonly used for progressive diseases such as cancer, dementia or advanced heart disease than for injury. In popular use, it indicates a disease that will progress until death with near absolute certainty, regardless of treatment. A patient who has such an illness may be referred to as a terminal patient, terminally ill or simply as being terminal. There is no standardized life expectancy for a patient to be considered terminal, although it is generally months or less. Life expectancy for terminal patients is a rough estimate given by the physician based on previous data and does not always reflect true longevity. An illness which is lifelong but not fatal is a chronic condition.

<span class="mw-page-title-main">Cicely Saunders</span> English nurse, social worker, physician and writer

Dame Cicely Mary Strode Saunders was an English nurse, social worker, physician and writer. She is noted for her work in terminal care research and her role in the birth of the hospice movement, emphasising the importance of palliative care in modern medicine, and opposing the legalisation of voluntary euthanasia.

<span class="mw-page-title-main">Ira Byock</span> American physician and author

Ira Robert Byock is an American physician, author, and advocate for palliative care. He is founder and chief medical officer of the Providence St. Joseph Health Institute for Human Caring in Torrance, California, and holds appointments as active emeritus professor of medicine and professor of community health and family medicine at the Geisel School of Medicine at Dartmouth College. He was director of palliative medicine at Dartmouth–Hitchcock Medical Center, from 2003–14, and associate director for patient and family-centered care at the affiliated Norris-Cotton Cancer Center.

End-of-life care (EOLC) is health care provided in the time leading up to a person's death. End-of-life care can be provided in the hours, days, or months before a person dies and encompasses care and support for a person's mental and emotional needs, physical comfort, spiritual needs, and practical tasks.

<span class="mw-page-title-main">American Academy of Hospice and Palliative Medicine</span>

The American Academy of Hospice and Palliative Medicine (AAHPM) is a professional organization for physicians specializing in Hospice and Palliative Medicine, headquartered in Chicago, Illinois. Membership is open to all health care providers committed to improving the care of patients with serious or life-threatening illnesses. AAHPM has more than 5,200 members; 82 percent are physicians, 12 percent are nurses or other health care providers and 6 percent are residents or students.

<span class="mw-page-title-main">Hospice care in the United States</span>

In the United States, hospice care is a type and philosophy of end-of-life care which focuses on the palliation of a terminally ill patient's symptoms. These symptoms can be physical, emotional, spiritual or social in nature. The concept of hospice as a place to treat the incurably ill has been evolving since the 11th century. Hospice care was introduced to the United States in the 1970s in response to the work of Cicely Saunders in the United Kingdom. This part of health care has expanded as people face a variety of issues with terminal illness. In the United States, it is distinguished by extensive use of volunteers and a greater emphasis on the patient's psychological needs in coming to terms with dying.

<span class="mw-page-title-main">Hospice</span> Organization that cares for the dying or the incurably ill

Hospice care is a type of health care that focuses on the palliation of a terminally ill patient's pain and symptoms and attending to their emotional and spiritual needs at the end of life. Hospice care prioritizes comfort and quality of life by reducing pain and suffering. Hospice care provides an alternative to therapies focused on life-prolonging measures that may be arduous, likely to cause more symptoms, or are not aligned with a person's goals.

Diane E. Meier, an American geriatrician and palliative care specialist. In 1999, Dr. Meier founded the Center to Advance Palliative Care, a national organization devoted to increasing access to quality health care in the United States for people living with serious illness. She continues to serve as CAPC's Director Emerita and Strategic Medical Advisor. Meier is also Vice-Chair for Public Policy, Professor of Geriatrics and Palliative Medicine and Catherine Gaisman Professor of Medical Ethics at the Icahn School of Medicine at Mount Sinai Hospital in New York City. Meier was founder and Director of the Hertzberg Palliative Care Institute at the Icahn School of Medicine in New York City from 1997 to 2011.

In 2006, hospice and palliative medicine was officially recognized by the American Board of Medical Specialties, and is co-sponsored by the American Boards of

Timothy E. Quill is an American physician specialising in palliative care at the University of Rochester Medical Center in Rochester, New York. He is also a board member of the Death with Dignity National Center in Portland, Oregon. Quill was the lead plaintiff in a case that eventually reached the Supreme Court of the United States in 1997, Vacco v. Quill, in which the Court decided that a state law against physician-assisted suicide was constitutional.

Anne Merriman, MBE, MCommH, FRCPI, FRCP is a British doctor, known for her pioneering work and influential research into palliative care in developing countries in Africa. She has campaigned to make affordable oral morphine widely available.

Margaret Ruth McCorkle FAAN, FAPOS was an American nurse, oncology researcher, and educator. She was the Florence Schorske Wald Professor of Nursing at the Yale School of Nursing.

<i>End Game</i> (2018 film) 2018 short documentary film by Rob Epstein and Jeffrey Friedman

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Kimberly Sherell Johnson is an American clinical investigator. She is a Full professor of medicine at Duke University and director of Duke REACH Equity. In March 2020, Johnson's academic work was recognized with the first Richard Payne Outstanding Achievement in Diversity, Equity and Inclusion Award from the American Academy of Hospice and Palliative Medicine.

Naheed Dosani is a palliative care physician based in Ontario, Canada, who founded and leads the Palliative Education and Care for the Homeless (PEACH) program. For his efforts in providing mobile healthcare to individuals with vulnerable housing or are homeless, Dosani has received a Meritorious Service Cross from the Governor General of Canada (2017), and a Canadian Medical Association Award for Young Leaders (2020).

Mary Jean Baines, OBE néeSilver was a British palliative care physician. Alongside her colleague Dame Cicely Saunders, she has been called one of the founders of the palliative care movement. She worked at St Christopher's Hospice in London from 1968 to 1997, and from there she established the United Kingdom's first community-based end-of-life care service.

<span class="mw-page-title-main">Doris Howell</span> American physician

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References

  1. Maynard, Kelly (2021-04-25). "Review: 'That Good Night,' by Sunita Puri". Star Tribune. Retrieved 2022-01-19.
  2. 1 2 Hulbert, Ann (2019-02-01). "What Medical School Doesn't Teach About Death". The Atlantic. Retrieved 2022-01-19.
  3. 1 2 3 Millstein, Jeffrey (September 16, 2019). "A physician-writer on stories and conversation as essential medicine for patients at the end of life". The Philadelphia Inquirer. Retrieved April 23, 2020.
  4. 1 2 Puri, Sunita (2019). That Good Night: Life and Medicine in the Eleventh Hour. New York: Penguin Random House. p. 2. ISBN   9780735223325.
  5. 1 2 3 Menendez, Alicia (March 6, 2019). "Physician & Author Sunita Puri on End of Life Care". Public Broadcasting Service. Retrieved April 11, 2020.
  6. "Sunita Puri: In the Borderlands Between Life & Death". www.pdsoros.org. Retrieved 2022-01-19.