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So far things are going my way. I am known in the hospice as The Man Who Wouldn't Die. I don't know if this is true or not, but I think some people, not many, are starting to wonder why I'm still around.

I have learned that delivering the best possible palliative care to children is vital, providing children and their families with a place of support, care and enhancement at a time of great need is simply life-changing.

Having been an oncologist and having cared for scores, if not hundreds, of dying patients, when you don't have a treatment that can shrink the tumor and the patient will die, it's a very difficult conversation. It's emotionally draining.

I am interested in the way advances in medicine and palliative care mean more people now have the opportunity to plan their own deaths, and also plan for those who are left behind. What does that do to the grieving process?

The bulk of my learning - if I may call it such - has come within the past three months, after I became a part of the fragile body of patients who make up an AIDS hospice. Here, surrounded by teams of supportive nurses, attentive doctors, and interns, one gently comes upon his own strengths and shortcomings.

Working with the dying is like being a midwife for this great rite of passage of death. Just as a midwife helps a being take their first breath, you help a being take their last breath.

The best care on earth cannot prevent us all dying in the end.

Openness about death has led to greater care about all aspects of dying.

Probably most dying patients, even when suffering greatly, would choose to live as long as possible. That courage and grace should be protected and honored, and we should put every effort into treating their symptoms.

When death is imminent and dying patients find their suffering unbearable, then the physician's role should shift from healing to relieving suffering in accord with the patient's wishes.