Lise Pedersen of Bispebjerg Hospital, Copenhagen spent two weeks on a TTS grant learning about pain and palliative care methods at Beth Israel Hospital in New York (2001).

June 6, 2001

During the last two weeks of March 2001, I visited the Department of Pain and Palliative Care at Beth Israel Hospital in New York. I had been so lucky as to get a scholarship from "The Thanks to Scandinavia Foundation" in relation to their program "Thanks to Scandinavia study visit program at Beth Israel Medical Center in New York" for doctors from Bispebjerg Hospital, Copenhagen, Denmark.

The aims for my visit were primarily to learn about the organizational structure of the department, the daily clinical practice and the research projects of the department, with special focus on fatigue and depression in terminal cancer patients and the treatment with psychostimulants.

When arriving to the department Monday morning a special agenda with a personal observership schedule had been made for my visit focusing on the above-mentioned learning objectives. Appointments had been made for me with the Chairman, Professor Russell Portenoy, the Director of the Institute for Education and Research, the Director of Nursing, the Director of the Supportive Services in the Cancer Center and the relevant Attendings Physicians, whom I followed in their daily work in the Hospice, the Hospice Homecare and in the out-patient practice and cancer pain service.

During the stay the different purposes of my visit were fulfilled. The organizational structure of the department, both the Pain Division and the Palliative Care Division, was quite different from that at home, and it was inspiring to see how it worked. Following the Attending Physicians I was impressed by the way they supervised and taught the Fellows. I have brought this with me home and implemented it in my own clinical teaching. It was also interesting to follow the pain specialists in the out patient practice and in the cancer pain service. To see how other specialists evaluate and treat different types of pain was very instructive. One of my special interests is the use of psychostimulants in the treatment of fatigue, depression and opioid side effects, and I generally find, that we use these drugs too little in Denmark in the treatment of cancer patients in the palliative phase. Observing the palliative use of psychostimulants in the out patient clinic and the hospice homecare supported this view. I also learned about the special fatigue project, and I brought home with me interesting new literature on fatigue, pain and teaching in palliative care.

Further I have made some valuable connections to other palliative doctors from Beth Israel, and I hope that some day our departments can do some relevant research studies together.

I could not stay away from my own department for more than two weeks, but being an observer I found this to be exactly the right amount of time to fulfill the intentions with my study visit. Even though I could have spent much more time in New York as a tourist. I most surely will return!

In conclusion I learned a lot from this study visit, which I can use on different levels in my own department of palliative medicine here in Bispebjerg Hospital, Copenhagen. I thank the "Thanks To Scandinavia Foundation" for giving me this opportunity to visit the department of Pain and Palliative Care at Beth Israel Medical Center in New York, and I thank the staff of the department for taking such good care of me and spending some of their valuable time on me.