As a child, Jessica Nutik Zitter, MD, wanted to grow up to be a superhero. More specifically, a doctor. “While other kids played with dolls, I was playing with my father’s doctor bag,” Zitter said. “I eventually outgrew my fascination with the doctor bag, but I never outgrew my fascination with wanting to save lives.”

Zitter – now an intensive care unit (ICU) and palliative care physician at Highland Hospital in Oakland, California – found her calling as a palliative care physician, a journey she shared Nov. 7 as the keynote speaker of the eighth annual Robert Leffert, MD, Memorial Lecture. Presented by the MGH Division of Palliative Care and Geriatric Medicine, the lecture honors Leffert, who served as chief of the MGH Department of Rehabilitation Medicine and the MGH Surgical Upper Extremity Rehabilitation Unit before his death in 2008.

“The palliative care experience is a continual questioning, struggle and journey of the ‘right way to die,’” said Lee Schwamm, MD, executive vice chairman of Neurology, chief of Acute Stroke Services and Leffert’s son-in-law. “And the services we have here now versus eight years ago – it’s almost unrecognizable.”

Schwamm said part of that is due to physicians such as Zitter and four MGH panelists – Emily Rubin, MD, Pulmonary and Critical Care Medicine; Kathryn Hibbert, MD, director, Medical ICU; Christine McCarthy, RN, Medical ICU; and Thabele Leslie-Mazwi, MD, Neurology Department – who have dedicated their careers to reorienting the care of dying patients to be a more collaborative process that puts the primary focus of care on the patient. They each spoke of the obstacles and successes they endure working in palliative care.

“We are faced with an incredible challenge,” said Vicki Jackson, MD, MPH, chief of the Division of Palliative Care and Geriatric Medicine, who moderated the panel. “How do we help patients have the best shot at a good outcome with all the new technology to avoid prolonging dying inappropriately?”

One important approach Zitter shared to help end of life patients is honesty – not only with patients, but with families, caregivers and colleagues. With the proper information in their hands, she said, patients can be empowered to choose a different kind of death, one in line with their preferences and values. “Patients can’t plan for a good death if they don’t know they are dying,” Zitter said. “We can’t always save their life, but we can save their humanity. And that to me is a new kind of heroism.”



Read more articles from the 12/14/18 Hotline issue.