Conversations with Dr. Jessica Zitter on Facing End of Life

On Tuesday, October 3, 2017, nearly two hundred people came to the Centennial Hall in Juneau, Alaska to hear critical care physician Dr. Jessica Zitter speak.  She recently wrote a book called Extreme Measures, which tells the story of her struggles to find meaning and purpose in her work with dying and critically ill patients in the intensive care unit of her hospital. 

Dr. Bob Urata, a well-known doctor in Juneau, and Ginny Palmer, former President of the Foundation of End of Life Care, completed a small panel to ask Dr. Zitter questions about her book and to ask what she had come to learn through her work.  The panel discussed a public health-care crisis in the United States, where people are dying in hospitals on ventilators and other machines without dignity or respect as the very ill reach the end their life. 

With an amazing kindness and gentleness, Dr. Zitter spoke of how the view of medicine changed with the invention of the iron lung during the polio epidemic. Patients who were very sick with polio and were struggling to breathe, were placed in a iron lung which helped them until they could breath on their own and they walked out of the hospital cured. Thus people’s view of medicine changed, if you went into the hospital very ill, the hospital’s equipment, used properly by trained doctors, could make you well.  Doctors began to use the increasingly powerful technologies even as patient’s bodies broke down and started to die. Often machines took over as the body’s organs died, leaving the patient in a limbo state, unable to move, actually tied to the bed and unable to speak because the mouth was filled with a breathing tube; feeding tubes replaced eating and tubes and machines were needed to support the heart and kidneys. A nurse named “Pat” helped Dr. Zitter see that she was hurting the very patients she was trying to help. Dr. Zitter was not recognizing that we all will die some day, and to have a good death is to die comfortably, surrounded by your family, and not hooked to machines. If given the choice, and the knowledge needed to choose, most people would rather die with dignity and surrounded by their families and by the people they love.   

The panel also talked about hospice and palliative care, both of which are important avenues as we reach the end of our lives. Dr. Zitter indicated that people know when they are dying and hospice and palliative care can not only ease their passing but also aid their loved ones in recovering from grief. Dr. Zitter pointed out that people in hospice care often live longer than people subjected to what are sometimes called “extreme measures.” She also recommended that medical doctors return to patient-centered medicine. Doctors need to relearn how to honor the patient at their end of life.

This program was filmed and will be shown on television.  The date and time will be posted on this website as soon as it is known.