• Rich Barlow

    Senior Writer

    Rich Barlow

    Rich Barlow is a senior writer at BU Today and Bostonia magazine. Perhaps the only native of Trenton, N.J., who will volunteer his birthplace without police interrogation, he graduated from Dartmouth College, spent 20 years as a small-town newspaper reporter, and is a former Boston Globe religion columnist, book reviewer, and occasional op-ed contributor. Profile

  • Robin Berghaus

    Robin Berghaus Profile

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There are 27 comments on Teaching Doctors How to Close Life’s Last Door

  1. Excellent article, thankyou. If only there were a support/supervision set-up for doctors willing to be “human beings” throughout their career.

  2. This is a very important topic. In fact, the Massachusetts Board of Registration in Medicine has just implemented a new End of Life counseling Continuing Medical Education (CME) requirement for physicians to maintain their license. Boston University School of Medicine’s CME office has a free online program on the topic which can be found on the BUSM CME website.


  3. Excellent article and video. Kudos to Charles Swanigan, and others like him, who are willing to give their (very) precious time to help train future health care providers.

    1. Mr. Swanigan and his family agreed to participate after Dr. Hardt discussed our story and video with them. The Swanigans consented to the use of family photos.

  4. It’s comforting to know that all-round care is becoming more common. Good pain relief is, of course, essential but people have an emotional need to come to terms with the fact that their lives are ending and to go peacefully. That’s important not only for the patient but also for the family. A good death brings solace to those who are left behind.

  5. The work Swanigan and his students are doing is important and necessary, and I hope future doctors are inspired by this great story and video. Great job Robin and Rich!

  6. Wonderful article. As in most cases the south is a little slower so house calls typically right now are for meeting the Medicare requirement for what is called a Face To Face visit between a patient on hospice and a medical doctor or CRNP operating on behalf of the hospice. Our hospice is a national company and we have partnered with Duke University to provide CME hours on Palliative Care Certification. Those who are members of the Board of Internal Medicine and the Board of Family Practitioners may take these courses (12 courses total) for free. The website is http://www.HospiceCME.com. Once you have taken this coursework you will be provided a certificiation of completion and will then be allowed to apply to sit for the National Test qualifying someone to become a Palliative Care Certified Physician. If you have any questions give me a call 205-249-6568

  7. Rich — thanks for this important piece. I tweeted in the hope it gets out to the palliative care community: “Progress! New docs learn #palliative, #endoflife care, #spirituality & cultural sensititivity. #hpm http://bit.ly/y6gFNb” For my colleagues at NYC’s HealthCare Chaplaincy, a leader in the research, education, and practice of multifaith spiritual care and palliative care for all people regardless of religion, beliefs or culture, we know well that the more physicians who embrace palliative care, the better will be the experience for patients and their families.

  8. Rich, thank you for an excellent article that highlights how important it is to treat patients holistically so that body, mind and spirit are all addressed as well as the impact of illness on the family. A couple of questions: Does the program include a board certified chaplain on the team? Chaplains bring expertise not only in assessing and working with spiritual issues, but also in cultural competence, communication, and integrating pt/family beliefs and values into the plan of care. A chaplain accompanying the physician on house calls would bring an important added dimension. Second question is whether the program curriculum includes a chaplain as educator. It would be a wonderful opportunity for two professions – physician and chaplain – to collaborate in such a program. Finally, HealthCare Chaplaincy offers free cultural competence materials on their website which can be downloaded to assist healthcare professionals, including A Dictionary of Patients’ Spiritual and Cultural Values for Health Care Professionals. They can be found at http://bit.ly/acXESS Again, thank you for this article and video.

  9. Mr. Swanigan was my uncle. He was soft spoken but a fighter. He so wanted to beat cancer. But in his trademark forward and logical thinking he accepted it. I am so thankful that I was able to spend the last six days of his life with him. That little chuckle giggle of his never waned unless he was in pain. I left Boston flying back to Virginia the day after Thanksgiving. About 10 minutes before my plane landed (I was asleep) .. something woke me up. As I was getting into the car for the ride home I got the call from my cousin that he had passed 30 minutes or so earlier. BTW That clarinet? We found it in the original case along with his diploma from the Boston Conservatory. His oldest grandson has it now.

  10. Charles Swanigan was my beloved father. The video is difficult to watch as so many different emotions come streaming back. However I do understand the need for this article in order for doctors to become more compassionate and knowledgeable about end-of-life care for patients. I am glad that it is being used as a learning tool. In my dad’s case many of his closest family members including grandchildren and cousin were able to be by his side during his final weeks. It is hoped that the love and attention given helped ease some discomfort and lighten the heart. We were also grateful for care received by Beacon Hospice. We miss you Dad…

  11. As a nurse, I feel we often have to guide many MDs towards what the patient and family want from the death process. To often they are bystanders to the end of life processes. I am pleased to read these stories about the newer approaches BU Med is doing. Over the last two years I specifically arrange chairs in a patient’s room and ask the MD to join in the conversation we are having with the family about end of life arrangements. I know the patient feels much more at ease with this approach.
    I find often we need to tend to the family needs as much as the patient.

  12. Addressing the very important holistic point, of body , mind and spirit to gear pt in making an imperative decision for his end of life care is utilized here. Its fortunate that this pt was able to make his own decision, and is possible for person on death bed to express their own wishes. In no way was his, dying pts wish coerced about the end of life care. Dr. Hardt did this very tactical, and aided the pt in making a right decision. Quality of life was respected in offering longer lasting pain meds, to see pt through painful episodes of cancer.
    I am please to read that this pt made it through Thanksgiving with his family at his side, and left this World in peace.
    Rich, this as an important topic you covered, for all of us to learn and make our wishes know.

  13. I agree with all of the above. It is important to know what the patient is feeling, what they feel they are missing and be able to provide support not only bodily but psychologically.

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