My guest is cardiologist Dr. Luis Pagan-Carlo speaking about the importance of having one of the most challenging conversations physicians must have in medicine today – helping patients talk about their thoughts and feelings about living with their illness when there is no further medicinal or surgical remedy available. 

Patients and physicians alike tend to avoid it. And yet both strive for a way to have a real conversation about the reality of their illness and the limits of medical intervention. 

Dr. Pagan-Carlo explores the various factors that help contribute to this "conspiracy of avoidance” and suggests that we - patients and their families as well as the medical community - need to devote attention to having these conversations in a straightforward, compassionate manner. He believes that patients and families are yearning for such a real dialog and are deeply appreciative of that opportunity. And that while it seems to fly in the face of the conventional practice of referring patients for one more procedure or med trial, a thoughtful and informed dialog really goes to the heart of what it means to be a physician. 

"The good physician treats the disease; the great physician treats the patient who has the disease." ~ William Osler