Hows & Whys
Kratom In the Chart
Kratom becomes clinically relevant because millions of people live in a health system where pain care is uneven and access to thoughtful longitudinal symptom care is thin.
Hows & Whys
What's R&R all about anyway?
Health Policy
The Disappearing Specialty, Part III
The AI infrastructure that will drive the next decade of cancer care doesn't have a signal for the work specialty palliative care does. As the AI hardens, the field gets quieter — not because anyone decided to silence us, but because the algorithm has no pattern for the patient who needs us.
Hows & Whys
The Disappearing Specialty, Part II
Walk into the website of any cancer center built or rebranded in the last five years and you will find palliative care's vocabulary doing work it didn't sign up for. Symptom management. Whole-person care. Goals of care. Supportive care. The words are everywhere. The specialty is harder to find.
Communication Skills
Beyond Mandatory Autonomy: Truth Without Abandonment
Honesty and hope aren’t opposing forces. They are a matched set: hope for the best and prepare for the worst—paired with an explicit promise of nonabandonment.
Hows & Whys
AI Won't De-Skill Palliative Care
The de-skilling threat is real and asymmetric across specialties. Palliative care sits on the protected side of that asymmetry—because the highest-value things we do are the things machines are worst at.
Hospice
The Rise and Fall of San Diego Hospice — Part 2
This is what happened at San Diego Hospice between November 2012 and February 2013. Leadership made a series of irreversible operational decisions — public disclosure, inpatient closure, live discharges, admission restrictions — while sailing entirely on estimated position.
Hospice
The Rise and Fall of San Diego Hospice — Part 1
How a “Mother Ship” Was Built: Ethos, Scale, and Blind Spots I trained at San Diego Hospice. In fact I was part of the last class of fellows. That sentence carries weight I've been unpacking ever since. SDH shaped how I think about dying, how I talk to
Health Policy
Hospice Caregiver Burden and the Systematic Delegitimization of Care
💡Start with Rachel Cohen Booth's excellent article in Vox, What happens when a city takes women’s unpaid work seriously? It catalyzed my thoughts below. Hospice prides itself on dignity at the end of life. But what about dignity for those doing the hardest work—unpaid caregivers? If
Changing the World
Augmented Intelligence in Palliative Care—Redesigning Care Delivery
Dr. Whyte's right—and in palliative care, the stakes are even higher.
Changing the World
The Monster We Built—and How Palliative Care Can Slay It
Let’s stop pretending that our health system is anything other than a Frankenstein’s monster stitched together from billing codes, productivity metrics, and cultural myths about heroism in medicine.
Communication Skills
What Kyle Learned Recently
From time-to-time, I will publish articles that have recently crossed my path with my analysis of what they tell us. This will be the first in that series.
Hows & Whys
Why in the World Would Anyone Listen to Me?
Why listen to me? Because I’m not here to sell platitudes. I’m here to share the soapboxes I stand on every day, bust the myths that make care worse, and offer the kind of practical wisdom you only get when you’ve sat at the bedside for thousands of hours.