Atul Gawande, the masterful writer and surgeon, writes in the New York Times about the complexities of end of life care. American medicine has done a poor job considering that patients may have priorities beyond just living as long as possible. His daughter's piano teacher, dying of an aggressive cancer, returned home with hospice care and regained some dignity and a chance to spend her final weeks of life doing what she loved - teaching piano. I think some serious work needs to be done so healthcare organizations and hospitals are better at fulfilling patients' goals that go beyond living as long as possible. How can medicine help patients find peace and dignity, make amends to those they care about and have their best possible days, even when the end nears?