If end-of-life discussions were an experimental drug, the FDA would approve it. - Atul Gawande

Pain is a symphony - a complex response that includes not just a distinct sensation but also motor activity, a change in emotion, a focusing of attention, a brand-new memory.

The result: those who saw a palliative care specialist stopped chemotherapy sooner, entered hospice far earlier, experienced less suffering at the end of their lives — and they lived 25 percent longer. In other words, our decision making in medicine has failed so spectacularly that we have reached the point of actively inflicting harm on patients rather than confronting the subject of mortality. If end-of-life discussions were an experimental drug, the FDA would approve it.

This was not guilt: guilt is what you feel when you have done something wrong. What I felt was shame: I was what was wrong.