2019; Volume 20, No 6, June

IAHPC Book Reviews

By Dr. Roger Woodruff, IAHPC Reviews Editor

Note for authors and publishers
If you wish to have your book reviewed, please send it to:

Dr. Roger Woodruff
IAHPC Bookshop Editor
210 Burgundy St, Suite 9
Heidelberg, Victoria 3084
Australia

Palliative Care Book of the Month

THAT GOOD NIGHT: Life and medicine in the eleventh hour

Sunita Puri
Viking (US), Constable (UK), 2019
320 pp, hardcover
Also available: Ebook, audio download
ISBN 978-0735223318 (US) 978-1472131331 (UK)
RRP $US17.70 £20.00

This is one doctor’s reflections on the meaning and practice of palliative care. As I perused her well-written stories, I immediately felt at home. Her undergraduate training and early residency had little to do with palliative care — ‘The effort to extend life left no space for accepting death.’ And as a resident she admitted ‘…because we ourselves can’t face the fact of a patient dying without trying something, anything, to keep them alive.’ There are candid discussions about the decisional dilemmas she faced as a resident and later as a palliative care fellow.

There a number of detailed descriptions of patients with serious illnesses and their family members, who are struggling with decisions about ICU admission, tracheostomy, feeding tubes, the goals of care, and CPR. At times, I felt I was in the room, struggling with the unreasonable relatives and copping some of their abuse. In my practice, I don’t remember so much having to push people to acknowledge the obvious or the inevitable, perhaps because I worked on an oncology setting rather than in general internal medicine.

I particularly liked her insightful descriptions of the unspoken as well as the spoken. She also tackles some difficult questions, such as when home care may not be the best option and why many physicians are wary of having difficult conversations with patients and their families.

In an interesting list of what different people may mean by ‘wanting everything done,’ I found this statement: ‘I want you to do all possible medical tests and procedures to cure my mother, all the things I see the doctors do on television, because those patients recover.’ I do not doubt that is what Puri may have been told, but I had to laugh that the comment came from a family member from Los Angeles! How apt that it’s the home of Hollywood, which has spread unrealistic dreams about serious illness for decades.

If you work in palliative care, you will both enjoy and benefit from reading this book. The situations and dilemmas she describes are only too real, and reading about how she sets out to deal with them will allow you to reflect on how you would have addressed them.

Dr. Sunita Puri is an assistant professor of clinical medicine at the University of Southern California, and medical director of palliative medicine at the Keck Hospital and Norris Cancer Center.

(Roger Woodruff, May 2019)

Other Reviews

THE ADVANCE OF HEALING: In service to caring for one another

Preston Edwards MD
Independently published, 2019
256 pp, softcover
Also available: on Kindle
ISBN 9781791732813
RRP $US15.00 £11.81

This is a collection of 42 stories or reflections, including a few poems, drawn from a lifetime in family medicine in rural Virginia and North Carolina.

What I liked was that it was about ordinary folk, many with little educational background, describing how they and their families responded to serious illnesses. It’s about the person in the patient. A theme is that ‘the transition from life to death can be made with comfort, peace, and relative ease, according to your wishes and beliefs.’ Several stories relate to allowing natural deaths or avoiding treatments that in all probability would be futile. Another was about the man undergoing CPR who may have heard uncharitable comments about himself from a judgmental physician.

Edwards says his stories are for everyone and not just health care professionals, which I am not in a position to judge. They deal with many of the human or personal aspects of death and dying, and I found myself remembering things from my own professional past. So for doctors and nurses, reading this book will help you remember and meditate about what is best when it comes to looking after people who are dying.

(Roger Woodruff, May 2019)

GUIDE TO PAIN MANAGEMENT IN LOW-RESOURCE SETTINGS

Andreas Kopf and Nilesh Patel (eds.)
International Association for the Study of Pain (IASP), 2010
317 pp; PDF
No ISBN. 
Free.

Whilst visiting the IASP Press website, I noticed this book, which had escaped my attention when it first came out. If it applies to your practice and you don’t already have it, check it out. It’s free.

While I have not reviewed it, to give you an idea of its content, here is the publisher’s description:

‘Educational material written for general distribution to health care providers by a multidisciplinary and multinational team of authors, the Guide to Pain Management in Low-Resource Settings [contains] easy-to-read information about simple and cost-effective approaches that can provide maximum effects in managing pain.

‘Topics range from the physiology and psychology of pain and principles of palliative care to management of patients with specific pain problems including various types of cancer, AIDS, sickle cell anemia, neuropathic pain, back pain, and visceral pain. Case reports provide illustrations of typical cases in the low-resource (often rural) setting in developing countries.

‘World-renowned experts provide chapters on setting up a pain management program, accessing resources for ensuring opioid availability, and setting up guidelines for local requirements. Authors with extensive clinical experience consider the integration of traditional medicines, modern pharmacotherapy (with consideration of the most cost-effective and readily available options), and techniques such as nerve blocks and radiation therapy.’

(Roger Woodruff, May 2019)

Roger Woodruff, MD (Australia)
Dr. Woodruff is a Lifetime Member of the IAHPC Board and Past Chair. His bio may be found here.

NB: Review copies become the property of IAHPC and are not returned to the author. Only books related to palliative care that have been approved and have an ISBN will be reviewed. Due to the large number of requests, we cannot provide exact dates of when books will be reviewed.

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