JOURNAL OF PALLIATIVE MEDICINE Volume XX, Number XX, 2017
My lesson on the incalculable value of chaplains came when I was doing some weekend moonlighting at a local hospice during my fellowship training. There was a younger woman in her late 40s dying of metastatic breast cancer. She was signed out to me as a ‘‘difficult patient with lots of mental issues’’ with pain that was extremely difficult to control. I don’t remember the doses of opiates, but they were some of the highest I had ever seen with a subcutaneous methadone infusion, dilaudid, and multiple other adjunctive medications. Both the hospice medical director and the pharmacist were struggling to find a solution that would help her stop screaming in agony.