“The only time doctors are left with “nothing more we can do” is when we fail to ask.”

Dr. Dawn Gross

Episode 23: Dr. Dawn Gross – A Physician with a Heart

How does a Stanford University graduate with a MD/PhD that includes specialized training in one of the most aggressive, cure-focused specialties in medicine―Hematology and Bone Marrow Transplants―find her way to palliative care? By being still just long enough for her life to find her.

Dr. Dawn Gross is uniquely qualified to lead a cultural revolution on end of life care. She holds combined degrees from Tufts University School of Medicine and the Sackler School of Biomedical Sciences, where she was trained rigorously as both a physician and scientist.

Beginning her practice as a hospice team physician, Dawn was invited to attend on the palliative care team at the University of California, San Francisco (UCSF).  She was subsequently recruited away to become the Arthur M. Coppola family chair for the Department of Supportive Care Medicine and clinical professor of hospice and palliative medicine at the City of Hope National Medical Center. Dawn wanted to be a scientist. She loved the science behind medicine and thought she would never aspire to become a practicing clinician. Yet, when her father was facing a serious illness, Dawn chose not continue on the scientific path she loved. That’s when she sat still long enough and allowed life to find her―and began to bake.

Dawn didn’t just bake anything. She baked a batch of cookies from her grandmother’s old recipe books. “Watching my dad eat the cookie from his childhood, he was transported to a place of pure happiness and joy,” she recalls. “This made me realize how important the small things in life truly are at the end of life.”

Upon her father’s admittance to hospice, dying only four days later, her grief took over.

Throughout her medical training, Dawn was taught to separate her emotion, putting boundaries between her own self and the patients she served. As a hospice medical director, she knew one thing. She did not want to be a physician that chose not to relate with her patients facing end of life. She found that she simply could not take her heart out of her practice.

Dawn returned to UCSF to join the newly formed palliative care committee within the San Francisco Department of Aging and Adult Services. In addition, she was invited to host a ground-breaking live, call-in radio program, Dying to Talk, broadcast on the oldest FM station west of the Mississippi, KALW 91.7 FM.

Her experiences as a hospice and palliative care physician have given her an unequaled perspective on how to care for people in their own homes. Whether attending patients in trailer parks or penthouses, there is no ivory tower. Dawn’s personal encounters as a mother and as a witness to her father’s death and her mother’s simultaneous serious illness inspired her to write and speak extensively about the work she does today.

Her writings have been published in a variety of medical journals, including:  Science, JAMA, Annals of Internal Medicine and San Francisco Medicine. A recent piece, “The Error in ‘There’s Nothing More To Do,'” was featured in the “Opinionator” blog of the New York Times.  Her recent work to develop a curriculum offering a “death-ed” class at Head Royce School in Oakland, CA, was also published in the New York Times.

Dawn’s written words based upon her distinguished medical career have one mission: to show us how we can live fully until we die. She is determined, both through her writings and by example, to improve how the medical community and medical protocol communicate with people about their potential dire prognoses.

Her undertaking is to assist patients and their families in dealing with the inevitable outcome of a life-ending health crisis with honesty and dignity. In the end, public policy must acknowledge and question incentives that prolong life with no appreciation for the impact on how we die. The public is just beginning to accept this dialogue and there is much more to be said.