End of an Era

Most of my postings have been about patients and their families who are facing serious, even life-threatening, illness. But there was a death recently in a different kind of family -- the hospice and palliative medicine family -- and I feel I must comment about its impact.

Not long ago, a pioneering institution in our field -- San Diego Hospice & Palliative Care -- closed its doors forever. SDH cared for patients throughout San Diego County -- almost a thousand on any given day -- but it was more than a hospice. Through its Institute for Palliative Medicine, San Diego Hospice trained physicians, nurses, and others in how to care for those near or at the end of life. Many of its graduates now hold leadership positions in hospice and palliative care organizations across the country. And through its international outreach, the IPM helped extend palliative care to people around the world.

Research, too, was part of its mission. We need better ways of caring for the myriad physical, emotional, and spiritual problems that patients and families encounter when they face serious threats to their health.

Much has already been written in my professional circles about the circumstances leading up to SDH's demise. There have been claims that the decision to close was premature, that the agency's financial problems could have been solved, and so on.

I don't know if any of those statements are true. But I do know that the world is less well off without the patient care, research, and education provided by San Diego Hospice & Palliative Care. At a time when there is universal consensus that we need more and better palliative care, the loss of this remarkable institution is, pure and simple, an unmitigated tragedy. I mourn its passing and hope we can recover.