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At Death's Door

End of Life Stories from the Bedside

Sebastian Sepulveda MD and Gini Graham Scott

At Death’s Door: End of Life Stories from the Bedside tells the powerful story of Sebastian Sepulveda’s experiences in working with patients at the end of their lives. In some cases, death came quickly, after the patient was first diagnosed with a terminal condition and entered the hospital. In other cases, patients had a long, progressive illness that got increasingly worse over the months or years until they were in their final days. In some cases, patients were able to fight off death for many years. Hard decisions are often made—whether to resuscitate or not, whether to choose hospice or not, who makes the decisions when a patient cannot, and whose decision to follow when several family members are involved in decision making. Written from the perspective of a medical doctor from years of experience, this personal approach to the end of life explores the many options available to patients and their families and reveals how real people have come to those decisions, and how they play out. With insight and sensitivity, Sepulveda offers families an important window into how life can end with compassion, care, control, and dignity.

At Death’s Door features over fifty stories drawn from Sepulveda’s experience as a doctor dealing with these patients and families. As states debate the legality of assisted suicide and other end of life rights, real people make real decisions every day regarding end of life. Their stories come to life in these pages, and readers with similar concerns will find relief, comfort, and company as they face these decisions themselves.
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Rowman & Littlefield Publishers
Pages: 278Size: 6 1/4 x 9 3/8
978-1-4422-7334-4 • Hardback • March 2017 • $38.00 • (£24.95)
978-1-4422-7335-1 • eBook • March 2017 • $37.99 • (£24.95)
Sebastian Sepulveda, MD, is a nephrologist in Chelmsford, Massachusetts. He is affiliated with Lowell General Hospital and has nearly 30 years’ experience as a doctor and professor of medicine, specializing in emergency medicine and end of life care. He has also worked as an Associate Professor of Medicine at the Medical College of Georgia, now known as Georgia Regents University in Augusta, Georgia. He has been a nephrology associate from 2000-2005 in Lowell, Massachusetts, and since then, has been in private practice, specializing in internal medicine, critical care medicine, and in nephrology, which deals with kidney problems. He has been a member of several professional organizations that deal with terminal patients, including the Society of Critical Care Medicine, the American Society of Nephrology, and the American College of Chest Physicians. He has received an award from the National Kidney Foundation’s North Carolina chapter, and has about a half-dozen publications in medical journals. He conducts workshops and seminars for patients with serious illnesses and family members to help them better understand and make arrangements for end-of-life care.

Gini Graham Scott is a nationally known writer, consultant, speaker, and seminar leader, specializing in business and work relationships, professional and personal development, social trends, lifestyles, and criminal justice. Scott has published over 50 books with major publishers and has published 40 books under her own publishing label ChangemakersPublishing, primarily on popular business and self-help topics. She has co-authored books with numerous writers, including Preventing Credit Card Fraud with Jen Grondahl Lee and American Justice? with Paul Brakke. She is a HuffPost regular columnist, she comments on social trends, new technology, and everyday life. Recent books include The New American Middle Ages, Scammed: Learn from the Biggest Consumer and Money Frauds Not to Be a Victim and Lies and Liars: How and Why Sociopaths Lie and How You Can Detect and Deal with Them. She has received national media exposure for her books, including appearances on Good Morning America, Oprah, and CNN.
From the vantage point of a highly experienced and thoughtful physician at the bedside, Dr. Sepulveda brings clarity to the decisions confronting patients, doctors and the 21st century health care system at the end of life. Using compelling case vignettes, Dr. Sepulveda writes with clarity about the pathophysiologic processes of the common fatal diseases of our time – COPD, heart disease, dementia, obesity and cancer – and how patients, their families and physicians face the dilemmas and decisions to be made at life’s end. Dr. Sepulveda brings to life how a compassionate and honest physician can help guide patients and their families in the hard decisions faced at life’s end.
Matthew S. Ellman, MD, Associate Professor of Medicine, Yale School of Medicine

Dr. Sepulveda provides an excellent overview of what we are likely to encounter in hospitals as we near death--whether our own or a loved one's death. This book is a worthwhile read for anyone preparing an advance directive or who is appointed to make end-of-life decisions for another. It also provides a useful introduction to end-of-life concepts and topics commonly encountered in U.S. hospitals.
Anita J. Tarzian, PhD, RN, Program Coordinator, Maryland Health Care Ethics Committee Network (MHECN); Law & Health Care Program, Maryland Carey Law; Associate Professor, University of Maryland School of Nursing