About Dr. James Hallenbeck

I am a retired physician living in the San Francisco bay area. I received my M.D. from Emory University, did a residency in Internal Medicine at the University of California, San Francisco, and a chief residency at Stanford Hospital. I spent my career at the VA Healthcare System in Palo Alto, CA near Stanford and was on the faculty at Stanford, retiring as an Associate Professor, Emeritus. I was fortunate to have found my way to the emerging field of palliative care in the early nineties. VA Palo Alto has one of the oldest hospice programs in the country. I served as its medical director for many years. I also was an administrator for VA Palo Alto’s extended care program, providing oversight of its nursing home and home care programs.

Throughout my career I enjoyed writing. I wrote for medical journals and wrote two editions of Palliative Care Perspectives (PCP), Oxford University Press. PCP grew out of a course on end-of-life care we developed at Stanford. While the overt focus was on medical trainees, PCP also found an audience with the lay public interested in palliative care. After retirement, I found that I wanted to keep on writing, free from the constraints of formal medical journals. Three things have been central to my writing efforts. First, I loved to explain complexities in ways that are easy to understand, creating stories, often based on evolutionary concepts. For example, I have outlined the pathophysiology of nausea, disgusting as this symptom is, based on its survival value protecting us against accidental poisoning. I have also been drawn to ‘interesting questions’ – queries that strike me as being of some importance, but which have mysteriously been neglected. For example, my article, Pathophysiologies of dyspnea explained, explores why opioids, like morphine, may help with shortness of breath without impacting one’s ability to breathe or one’s survival. Finally, I love history. I have written about the history of palliative and how our views on death and dying in western culture have changed over time.

I am now taking these passions in new, overtly disparate directions. My debut novel, Operation Reboot, examines the big question, why is it that mankind seems hellbent on self-destruction? Is it simply our nature to grow and expand until Mother Nature puts a stop to our recklessness or were there correctable ‘flaws’ in our history, in how we evolved as a species? I do this in a time-travel piece in which people from the future travel back to pre-colonial North America in the early 1600s, prior to the arrival of the Mayflower. They hope to aid the indigenous Mohawk resist European aggression, thought to be a key factor in the fall of civilization. They want to start something new, to ‘reboot.’ What exactly that new civilization might look like, they aren’t quite sure. The Mohawk were chosen because they had strong egalitarian and democratic tendencies. The novel also allows me to explore the fascinating history of that important age.

I’m on more familiar turf in the other book I’m working on. It explores chronic illness and aging with a lay target audience. I’ve been fascinated, not in a good way, by the fact that despite spending more on healthcare than any nation on earth, our system of healthcare seems broken. In reflecting on my career, it occurred to me that I was rarely asked by my patients or their families how to ‘do’ whatever affliction was besetting them. How does one ‘do’ heart failure or dementia, for that matter? While there is no shortage of information online about common chronic illnesses, still developing a strategy for surviving the gauntlet that is modern medicine in America is hard. In the book I try to guide readers through common barriers they may encounter – knowledge deficits about the basic physiology of common chronic conditions, communication challenges with professionals and family members, and nitty-gritty aspects of medical care – the finances of healthcare and the peculiarities of venues of care (acute care, outpatient care, home care, and nursing home care).

In follow-up posts I hope to expand on the topics above and provide references for those who wish to explore them further, whether they relate to topics like the history of indigenous people or some aspect of medicine. Please feel free to follow what strikes your fancy and ignore the rest.