What's R&R all about anyway?
Hows & Whys
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
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
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
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
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
💡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
Dr. Whyte's right—and in palliative care, the stakes are even higher.
Changing the World
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
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 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.
Hows & Whys
If you want evidence-driven insights, humor, and the occasional rant that makes you rethink how we care for people when it matters most, welcome aboard.