ABSTRACT
This chapter focuses on the terminal stage of the terminally ill from the point of view of their medical team. Torture, execution, and abandonment may seem unnecessarily harsh terms, but they correspond to the feelings that can be engendered in the treating staff by this population of very ill patients. These countertransference reactions can lead to suboptimal patient care and a recurrently painful work experience. The chapter addresses each of these three reactions by using illustrative cases from my work as a psychiatric consultant within a large hospital. In each case, there are accessible therapeutic approaches that allow for a more gratifying experience for both the dying patient and the caretaker. The medical and surgical team agreed that there was no way that Mrs. Alexander would survive. She was in constant pain, grimacing and moaning whenever she was moved or touched.
