This excerpt from Dr. Ira Byock's book, "The Best Care Possible: A Physician's Quest to Transform Care Through the End of Life," addresses use of the "surprise question" -- some variation of "Would you be surprised if this patient died in the next year?" -- to screen patients for palliative care. Byock, director of palliative medicine at Dartmouth-Hitchcock Medical Center, tells of a relative, Edith, whose condition declined while she was in the hospital but improved so much at home with hospice care that she "graduated" from the program and eight years later is going strong.

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