Welcome back, everybody. I was just reading an article that was stuck in my article pile list,

and this one is actually back from October 17th of 2020, but it struck me that I probably should

talk a little bit about this. As many of you know, I have a soft spot in medicine for when we do

things a certain way, either because

of logic or out of fear, and then we find evidence-based medicine that makes us question whether

we were practicing the correct way. And as you get older, you have more and more of these

experiences in medicine. And I would say that the thing that's making me feel old these days is aging.

And the other thing that makes me feel old is I actually read medical studies, which

I'm learning more and more is not done as much these days.

I have been recently told that CME money in our department is rarely spent on journal subscriptions

because nobody reads journals anymore. So for those of you who don't, you can listen to dinosaurs

like me. So this article was from the August 17th, 2020 Journal of American Medical Association,

and it was titled, Effect of Sustained Release Morphine for Refractory Breathlessness and Chronic Obstructive Pulmonary

Disease on Health Status.

And I just got out of breath saying that entire title without taking a breath.

So maybe I should get my PFTs checked.

In the meantime, let me tell you about this trial. It was a small

trial, but it was a randomized clinical trial. And the patients that were randomized had advanced

chronic obstructive pulmonary disease. Now, many of you who treat this, of course, know

that we're very limited in what we can do with this disease, meaning once we've

maximized all the long-acting and short-acting inhalers, sent people to pulmonary rehab,

utilize oxygen therapy, you know, there are other measures. But the fact is, is that when

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