Cleo was admitted to the hospital after suffering a major seizure one day while doing her laundry. A brain biopsy a few weeks later revealed a glioblastoma, an aggressive and malignant form of brain cancer. The surgeon laid out the prognosis, cut and dried: she had less than three months to live. He urged her to go ahead with surgery and a chemotherapy follow-up. It would give her perhaps an extra nine months to a year, he said, but ultimately the cancer was terminal. Cleo explained how, despite her initial reaction to let nature take its course, she felt she should go ahead with the surgery for the sake of her 87-year-old mother, who was devastated by the diagnosis.

Seigan listened carefully.

"Can I challenge you for a little bit?" he asked. "What do you really want?"

It's the question that is slowly but steadily refocusing end of life care. As a member of the interdisciplinary palliative care team at one of New York's major teaching hospitals, Seigan is part of a growing push to make health care more holistic -- treating the whole person rather than just focusing on the disease. Trained as a chaplain through the New York Zen Center for Contemplative Care (NYZCCC), he works to champion patients' quality of life and help them prioritize their personal goals and values.

"I encounter people at a vulnerable time, a time of crisis," Seigan explained. "I'm there to walk them through this journey in some way -- not fix them so much as to listen, to offer or reflect back to them their strengths, fears, their own existential support systems and what gives them meaning in their life."

The message that the palliative care team is trying to convey to the world of aggressive medical intervention is a straightforward one: healing people doesn't necessarily mean saving lives. "More and more we are refusing to acknowledge important aspects of what it is to be human, including death," Seigan points out. "People want to talk, they want to be heard and understood. But a lot of the time what we see in health care is a breakdown of communication."

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Part of the problem, palliative care nurse practitioner Cathy Mondonedo argues, is that doctors have come to see death as failure, prioritizing extension of life over quality and comfort -- a mentality that is then projected onto patients and their families. "Its not that physicians aren't well-meaning, they just don't know how to approach this topic and don't want to look like they are giving up, but aggressive treatment is not always the best option," she said. "It's important that people are given realistic expectations about their illness so that they have time to have these difficult conversations and make plans for the future."

But confronting death is not easy. The Journal of Palliative Medicine reported in 2010 that only around 20 percent of terminally ill elderly patients had their end-of-life wishes documented in their medical records. Much of the painful end-of-life decision-making is then shifted onto family members, who are frequently left feeling isolated and pressured into pursuing invasive treatments. As a result, despite the majority of Americans voicing the desire to die in comfort at home, CAPC statistics show that around 80 percent of deaths still occur in hospitals and intensive care units.