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Perspectives on Care at the Close of Life: CODA
JAMA. 2001;286(23):3002. doi: 10.1001/jama.286.23.3002

Psychological Considerations, Growth, and Transcendence at the End of Life

The Art of the Possible

Since this article does not have an abstract, we have provided the first 150 words of the full text.

Let it come, as it will, and don't
be afraid. God does not leave us
comfortless, so let evening come.
—From "Let Evening Come," Jane Kenyon (1996)

In June 2001,1 Susan Block, MD, introduced Mr N, aged 77 years, a divorced systems analyst with end-stage pancreatic cancer metastatic to the liver and lungs; Mr N's adult son; and his treating physician, Dr S. Each described the psychological challenges, and illuminated the potential opportunities for personal growth and deepening of relationships, that the end of life offers. Careful attention to Mr N's physical symptoms and suffering made it easier to address his central concerns—about family, his own psychological integrity, and about finding meaning in his life.

Four months after Mr N's June 1999 interview, his condition worsened. Mr N called Dr S to say that he was experiencing marked anorexia and increasing weakness and was thus unable to come to …

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