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Did you see the story about the robot doctor that was sent to deliver bad news to a terminal patient? His daughter was with him when the telehealth machine rolled up to his bedside. On the flickering screen, a physician informed the patient that he was going to die, very soon – perhaps too soon to go home. Daughter Catherine was appalled at the coldness of what should have been a human interaction. So were a lot of other people; so was I.

The story went viral on social media, prompting somewhat clumsy efforts by Kaiser Permanente to tamp down the overwhelmingly negative response. But there no denying the pain this awful misstep had caused: "My dad's reaction was, well I guess I'm going to go quickly then and put his head down-- that was it," said daughter Catherine Quintana.

A prognosis that would have been difficult to accept under any circumstance, became even more painful for the Quintana family of Fremont when the doctor used a robot to deliver the bad news.”...

As 2017 draws to its close most of us are going to find ourselves reflecting on the year that’s passing, and taking stock of our personal balance sheet to see how we did. Did we squander our capital – our time, our health, our relationships – or did we build on it, by following through with our good intentions and doing just a little better in some of those spheres than we had in previous years?

           Making this kind of personal reckoning can be frustrating, because our intentions so often outstrip our actions. We all want to be more mindful and more intentional – I certainly do! – but life has other plans and we’re so often caught up in dealing with what’s coming at us in the moment that we lose the clarity that the long view brings. The holidays are difficult for people, I think, because they shine a bright light on how we’ve used our time on earth in that last 365 days,...

In honor of the beautiful holiday of Thanksgiving I want to share a story about saying "thank you". Have you ever had a friend that simply made you want to be a better person just by knowing them?  Laura Carmichael was that person for me.  Ms. Laura was my role model for living a purposeful life, enjoying each day, giving back in small and large ways and always saying “Thank You”.

Laura had the corner market on writing “thank you” notes.  Her notes were legendary, no sooner had the gift been delivered, than she was at the post office with her thank you note ready to mail.  Ms. Laura probably had heavenly choirs singing each time her delicate fingers hit the typewriter keys.  She penned her notes until her hands had such a tremor that at age 101 she couldn’t write legibly so used the trusty Royal. 

For over 60 years Ms. Laura clipped the good news from the local newspaper, accomplishments by ordinary people, and sent them a...

Mission, Purpose and Passion. 

The last of these is PASSION.  So if you Mission is your overarching architecture of the building, and the purpose is what you are doing inside that building, then PASSION is the electricity that runs it.

Mission and Purpose without PASSION is like having the logs in the fireplace and not having a match to get it started. 

PASSION is the energy that's needed to move your Mission forward, because when all three are present, and they are all in alignment ... it really is magic. 

Work becomes easy, obstacles melt away, challenges become opportunities, and work is something you do because it is your life, not because it is your job.

When I was working at the Health Services, I thought being a clinical nurse practitioner would be terrific.  My personal Mission of serving those in need was present, my Purpose of improving the health of those in served was being met, but I didn't have any PASSION.  There was no spark to ignite...

Why do you get up in the morning?  Why do you go to work each day?  It is simply for the paychex?  Or the insurance?  Or is it because you too want to make a difference in the world?  And I would ask you... are you making a difference?  What is it that you are doing each day to ease suffering and empower others.

Let's talk about empowering others.  It comes in all sorts of ways.  As part of my consulting work, i facilitate workshops and retreats, and I love this kind of work because it allows me to see people with appreciative eyes.  When we talk about our superpowers, we are not talking about x-ray vision, or leaping tall buildings, but rather the special strengths we bring to our teams.  The qualities of character or personality we bring to our teams are often characterized are often shrug off as "it's just who we are".

At a recent workshop with a senior team, I asked them what they liked best about their job.  One of...

November is National Hospice Month; a month in which the nation’s attention should be on the wonderful care and support hospice organizations provide to dying people and their loved ones.  Unfortunately, this month we are still reeling from Time magazine’s October 25^th article, No One is Coming: Hospice Patients Abandoned at Death’s Door.

I have dedicated my professional life to working in hospice care, to helping people and organizations be their best, and the vast majority of hospices strive every day to do just that. But for those whose experiences of neglect and unanswered phone calls are the basis of the Time article, our track record and good intentions mean nothing.

In response to the piece, the President and CEO of the National Hospice and Palliative Care Organization Edo Banach wrote in part in his letter to the membership, “…The authors cite 3,200 complaints filed with state officials in the past five years.  During that period,...

Image Above: Tom Petty receiving a distinguished achievement award from University of Florida First Lady Chris Machen

I Won’t Back Down is one of the best-known songs written and performed by Tom Petty, Rock and Roll Hall of Fame legend and leader of the Heartbreakers, who died suddenly this past October 3^rd.  Like all of his music, it resonated for me, and it’s not a stretch to say that the Heartbreakers have been the sound track of my life.  

            Gainesville, Florida has been my home for nearly all of my adult life. I love this town, the people, the beauty of the environment and the University of Florida. Tom was our native son:  He and two of his band mates from the Heartbreakers grew up in Gainesville, developed their sound here and still have family here. Tom’s first cousin Sadie Darnell is our current sheriff.

            When...

When I talk with my clients lately, it seems nearly everyone has been grappling with a decrease in census.  Are people just not dying as frequently as in the past? Are other providers stepping up to offer similar types of care thus sidestepping hospice or is it some other mysterious thing that is happening?!

We pursue referrals in all kinds of ways; we pass out brochures at doctor’s offices, assisted living communities, and senior centers; we give logo pens to discharge planners who we hope will call us looking for hospice care. We may pay search engines to put our ads above other results, when people go online to search phrases like “hospice near me”. These are all solid strategies – but do they go far enough?

Part of the challenge in engaging the community is that we’re balkanized in the public imagination because of the function we serve.  It’s not news that people are by and large afraid of death – and though we as hospice...

Thank you all for your kind support over the past couple of weeks. Irma packed a wallop on the entire state of Florida.  She was unpredictable in her exact path and her girth was so wide she reached from the Atlantic to the Gulf, wider than any hurricane ever to set an eye on the shores our Sunshine State. She left only the far western tip of the panhandle untouched by her fury.

The lessons Irma provided were valuable and I hope to keep them alive much longer than it takes to rebuild from her destruction. What do you take with you when you fear your home might be severely damaged or destroyed? I have often thought about this, photos, letters, mementos, clothes?  I discovered, when it came right down to it, there wasn’t much I needed.

My responsibility was to be sure my 93-year-old mother in law was safe and out of harm’s way so we flew to Nashville, a wonderful city with generous people and wonderful food! I had a few hours to pack before we left and wondered...

  Image Above: Beach sand magnified 250 times

  Last time, I wrote about the importance of taking a moment and “taking a knee” to acknowledge the human being in our care; of looking beyond the chart, if you will, to honor our common humanity. It’s easy to lose sight of that when care providers are running on empty, overwhelmed and skating on the edge of frustration as so many do. And yet, we too are only human, and some days, that doesn’t feel like enough. I’d been thinking a lot about that this past week – and then this poem found its way into my inbox, sent along via a friend. Coincidence? I think not.

            It takes the words of someone as thoughtful and caring as Heidi O’Neil to remind us of the profound and – yes - holy nature of what we undertake in caring for the dying, and to remind us how much they give us in the process.  They are our teachers.

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