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Spring 2014
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Meet the Fellow
Rachel Rackow is Alpert Medical School’s first fellow in palliative medicine.

Six years ago, when Rachel Rackow MD’09 RES’12 was halfway through medical school, her phone rang one evening as she was heading out to a concert. It was her mother, bearing devastating news. Rackow’s 24-year-old sister, Emily, had not shown up at work that day. A visit to her Washington, DC, apartment by co-workers and police revealed that Emily had died of a brain aneurysm that morning.

The circumstances of Emily’s death forced her family to grieve in shock. But it doesn’t have to be that way for every family. Rackow’s mission is to prepare people for the full continuum of life, right up until the end.

In June, Rackow was named Alpert Medical School’s first fellow in palliative medicine, under the auspices of a new agreement that makes Home & Hospice Care of Rhode Island Brown’s major teaching affiliate for hospice and palliative medicine.

“Home & Hospice Care is well known for providing skillful and compassionate care. We are pleased that this agreement formalizes our long-standing relationship with them and our commitment to ensure that Alpert Medical School students have been trained in the specialized and unique care of patients and their families in the last months and weeks of life,” said Edward J. Wing, MD, dean of medicine and biological sciences, in announcing the affiliation.

Wing noted that Brown enjoys a long and distinguished relationship with HHCRI, dating back to the role of Dean Emeritus Stanley Aronson, MD, in founding the organization.

“Elsewhere in the world, death is more likely to be seen as part of life—no less painful, but part of life,” says Rackow, who holds a master’s in public health, with a concentration in international health, from Harvard University and has worked in Rwanda and Burundi. “In this country, it’s the elephant in the room that no one wants to acknowledge. We do everything we can to stave off death, rather than helping people die well.”

“One of the biggest issues during my internal medicine residency was dealing with end-of-life issues, talking to families about whether they were going to pursue palliative options when people weren’t doing well,” she remembers. “The idea that treatment is not always going to be curative is such a jarring concept for a lot of people. Whenever I helped a family make a decision, it was always very satisfying.”

“When I tell people that I’m going into palliative care medicine, they often say ‘That’s so depressing,’” she continues. “I think it’s much harder to watch people go through painful— and often futile—treatments at the end of life. It’s so much better to be able to help people have a good death, or to give them medication and see their pain symptoms relieved.”

In addition to helping to frame the conversation about end-of- life care, Rackow notes, palliative care specialists develop a finely-honed, very specific repertoire of clinical skills. “When I did my [medical school] rotation with Dr. Martin, I got a taste of what people in the palliative care world know about pain management and symptom relief—that medications that we use for anxiety can also help with nausea, for instance. I’m looking forward to exploring the clinical side.”

Rackow starts her fellowship in October. She’s been busy focusing on the very beginning of life—getting acquainted with her new daughter, Ella, who was born in June and named for her sister Emily.
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