Author: endoflifeliteracy1


You will have patients you grow close to or don’t even know die while under your care. Some will be traumatic. Some will be peaceful and quiet. These experiences will change and affect you, and there are several coping mechanisms you will employ while processing these experiences over time. Literature, to us, is a powerful tool in helping you cope with patient deaths. With physician suicides near 400 per year in the US, and substance abuse and dependence among medical students and residents above 10%, we wanted to offer more resources to help you in your process of coping with death.

Because so much about what you learn in having death and dying discussions comes from mentors, we asked physicians what books stood out to them most in dealing with patients dying. The most common responses are listed below.

book_breathWhen Breath Becomes Air by Dr. Paul Kalanithi, MD

At the age of thirty-six, on the verge of completing a decade’s worth of training as a neurosurgeon, Paul Kalanithi was diagnosed with stage IV lung cancer. One day he was a doctor treating the dying, and the next he was a patient struggling to live. And just like that, the future he and his wife had imagined evaporated. When Breath Becomes Air chronicles Kalanithi’s transformation from a naïve medical student “possessed,” as he wrote, “by the question of what, given that all organisms die, makes a virtuous and meaningful life” into a neurosurgeon at Stanford working in the brain, the most critical place for human identity, and finally into a patient and new father confronting his own mortality.

What makes life worth living in the face of death? What do you do when the future, no longer a ladder toward your goals in life, flattens out into a perpetual present? What does it mean to have a child, to nurture a new life as another fades away? These are some of the questions Kalanithi wrestles with in this profoundly moving, exquisitely observed memoir.

Paul Kalanithi died in March 2015, while working on this book, yet his words live on as a guide and a gift to us all. “I began to realize that coming face to face with my own mortality, in a sense, had changed nothing and everything,” he wrote. “Seven words from Samuel Beckett began to repeat in my head: ‘I can’t go on. I’ll go on.’” When Breath Becomes Air is an unforgettable, life-affirming reflection on the challenge of facing death and on the relationship between doctor and patient, from a brilliant writer who became both.


Being Mortal by Dr. Atul Gawande, MD

Medicine has triumphed in modern times, transforming the dangers of childbirth, injury, and disease from harrowing to manageable. But when it comes to the inescapable realities of aging and death, what medicine can do often runs counter to what it should.

Through eye-opening research and gripping stories of his own patients and family, Gawande reveals the suffering this dynamic has produced. Nursing homes, devoted above all to safety, battle with residents over the food they are allowed to eat and the choices they are allowed to make. Doctors, uncomfortable discussing patients’ anxieties about death, fall back on false hopes and treatments that are actually shortening lives instead of improving them. And families go along with all of it.

In his bestselling books, Atul Gawande, a practicing surgeon, has fearlessly revealed the struggles of his profession. Now he examines its ultimate limitations and failures – in his own practices as well as others’ – as life draws to a close. And he discovers how we can do better. He follows a hospice nurse on her rounds, a geriatrician in his clinic, and reformers turning nursing homes upside down. He finds people who show us how to have the hard conversations and how to ensure we never sacrifice what people really care about.

Riveting, honest, and humane, Being Mortal shows that the ultimate goal is not a good death but a good life – all the way to the very end.

book_ondeathanddyingOn Death & Dying by Dr. Elisabeth Kubler-Ross, MD

Ten years after Elisabeth Kübler-Ross’s death, a commemorative edition with a new introduction and updated resources section of her beloved groundbreaking classic on the five stages of grief.

One of the most important psychological studies of the late twentieth century, On Death and Dying grew out of Dr. Elisabeth Kübler-Ross’s famous interdisciplinary seminar on death, life, and transition. In this remarkable book, Dr. Kübler-Ross first explored the now-famous five stages of death: denial and isolation, anger, bargaining, depression, and acceptance. Through sample interviews and conversations, she gives readers a better understanding of how imminent death affects the patient, the professionals who serve that patient, and the patient’s family, bringing hope to all who are involved.

This edition includes an elegant, enlightening introduction by Dr. Ira Byock, a prominent palliative care physican and the author of Dying Well.


Dying Well by Dr. Ira Byock, MD

Nobody should have to die in pain. Nobody should have to die alone.

This is Ira Byock’s dream, and he is dedicating his life to making it come true. Dying Well brings us to the homes and bedsides of families with whom Dr. Byock has worked, telling stories of love and reconciliation in the face of tragedy, pain, medical drama, and conflict. Through the true stories of patients, he shows us that a lot of important emotional work can be accomplished in the final months, weeks, and even days of life. It is a companion for families, showing them how to deal with doctors, how to talk to loved ones—and how to make the end of life as meaningful and enriching as the beginning.

book_howwedieHow We Die by Dr. Sherwin B. Nuland, MD

A runaway bestseller and National Book Award winner, Sherwin Nuland’s How We Die has become the definitive text on perhaps the single most universal human concern: death.  This new edition includes an all-embracing and incisive afterword that examines the current state of health care and our relationship with life as it approaches its terminus.  It also discusses how we can take control of our own final days and those of our loved ones.

Shewin Nuland’s masterful How We Die is even more relevant than when it was first published.


Palliative Care: A Different Kind of Hope by Dr. Patrick J. Macmillan, MD

Palliative medicine is one of the greatest gifts we have to offer folks at the end of their life or during the chronic phases of illness. Patrick J. Macmillan, MD, conveys that message loud and clear in this book featuring sixteen poignant stories of patients who found themselves at the end of life. Chaplains, nurses, social workers, and others play an important role in each tale. You’ll meet Grace, who wanted to keep fighting even though she had pancreatic cancer. Her family wanted her to keep battling as much as she did, but eventually she had to tell them that she didn’t want any more interventions. While doctors were unable to save her life in the conventional sense, they helped her spend her final days at home with loved ones. She is just one of many brave souls who have fought the good fight but eventually realized that surrendering to death offered their best hope at living with dignity.


Death and Dignity: Making Choices and Taking Charge by Dr. Timothy E. Quill

This book looks squarely at how patients can make crucial decisions and take charge of the end of their lives. This book is a resource for anyone who fears unnecessary suffering and excessive medical intervention at that point. It helps readers think through and then complete advance directives, and also to take a more active role when they or a family member becomes terminally ill. Through real-life stories and his own experience, Dr. Quill explores what measures a patient can choose to prolong life and how to forgo such measures if they begin to extend a painful death, choosing instead approaches such as comfort care which emphasize quality more than quantity of life. Finally, Dr. Quill speaks out on physician-assisted suicide and why he helped a long-term patient of his, stricken with leukemia, to take her life when her suffering became intolerable. He asks for regulation, rather than denial, knowing that many patients and doctors often face this question at times of crisis.

book_conversationThe Conversation: A Revolutionary Plan for End-of-Life Care by Dr. Angelo Volandes, MD

There is an unspoken dark side of American medicine–keeping patients alive at any price. Two thirds of Americans die in healthcare institutions, tethered to machines and tubes at bankrupting costs, even though research shows that most prefer to die at home in comfort, surrounded by loved ones.

Dr. Angelo E. Volandes believes that a life well lived deserves a good ending. Through the stories of seven patients and seven very different end-of-life experiences, he demonstrates that what people with a serious illness, who are approaching the end of their lives, need most is not new technologies but one simple thing: The Conversation. He argues for a radical re-envisioning of the patient-doctor relationship and offers ways for patients and their families to talk about this difficult issue to ensure that patients will be at the center and in charge of their medical care.

It might be the most important conversation you ever have.



As in all medicine that we study, the sources used when researching a topic can be valid even if it’s not in an academic journal. Just as NEJM and JAMA have their place in providing information, places like Wikipedia do just as well when we need a reminder of what some receptor we haven’t studied since Step 1 does.

Dr. Tom Townsend, MD is a Family Medicine physician who specializes in Geriatrics, and has over 40 years of clinical experience. He has helped found 3 hospice houses in rural underserved Appalachia, taught hundreds of medical students and residents, been on several national coalitions and committees for advancing ethics and humanities education into medicine, and established and teaches an end of life care ethics and humanities course for medical students and residents.

In the Academic section, you’ll find published journal articles Dr. Townsend uses as teaching tools from his end of life care course. In the Media section, you’ll find articles from places like the New York Times, Huffington Post, The New Yorker, etc. that he has specifically selected for their utility in opening discussions about death and dying in our changing culture. You will find his comments and article descriptions useful in delineating the specific information you need, whether academic or personal. Some will help in your coping with losing patients, while others will educate and empower you in the process of dealing with death and dying.



Reading about death and dying discussions and stories is a way to build your vision, theory, and philosophy of how you will communicate with patients in your moments with them – the framework to a house, if you will. However, it’s through film we can see the nuances of non-verbal communication; we ingrain music that ebbs and flows with the conversations unfolding before us – the character and comfort that make a house a home, if you will.

Through film and educational videos, we hope to offer more than checklists, but a way to understand how you connect in the bigger picture of a patient’s final months, weeks, days, or moments. Death and dying can often weigh heavy on a young physician, and the modalities included are meant to inform and empower, but most importantly, be a cathartic release and allow time for processing in what will be some of your most memorable patients.

The TED Talks are a way to think about some bigger picture issues in death and dying, while the Education section is tailored more as specific instruction regarding end of life care.