Tuesday, March 18, 2014

Remembering Palliative Care Pioneer: Marion Pohlen Primomo, M.D.

May 15, 1920-March 1, 2014

When I think of people who have paved the way to make my professional career possible I think of Dr Marion Primomo. Not only was she one of the first women physicians; It is fair to say that she is the mother of the hospice movement in Texas.  She was one of the founders of the first hospice in San Antonio in 1978. She was a Founding Member of the Academy of Hospice and Palliative Medicine and the International Association of Hospice and Palliative Medicine.  In the 1980s, she had established an elective for medical students on their family medicine rotation in which medical students visited patients on hospice and their caregivers.  In the late 1990s she led the efforts to establish the palliative care fellowship program at Universityof Texas Health Science Center at San Antonio (UTHSCSA). The fellowship was a possibility because of Dr.  Primomo’s leadership to combine efforts from community hospices, UTHSCSA and the Veterans Affairs. She served as the first fellowship director. 

Dr. Primomo With Dr. Mark Prange.
As a medical student Dr. Prange visited dying patients and their families with Dr. Primomo
As a fellow, I interacted with Dr. Primomo teaching palliative care to the residents, when she was well into her 80s. She was always very energetic and ready to teach, she would have already read the latest article of  the New England Journal or other journal that have been published that week.  She taught us about opioid conversions, gave us a detailed palliative care must reads list, and more importantly she inspired us to be better healthcare professionals and human beings.  I still think of her as the type of person I want to be “when I grow up”.

You can learn more about the history of palliative care in Texas and get a sense for the wonderful person Dr. Primomo was in this YouTube video of her February 2008 Grand Rounds. The quality of the video is a little bit grainy but you can hear her well.

Dr. Primomo was an outstanding mentor, teacher and clinician.  Her efforts, vision and uncompromising passion have set the foundation for us to continue growing the programs in palliative care medical education and making it possible for us to have a strong palliative care fellowship that today is one of the largest inter-professional fellowship programs in the nation and a well-established clinical program where many patients and families find comfort and symptom relief.

Rest in Peace Dr. Primomo. I hope you know that you have paved the way for us to continue to make a difference in the lives of those who are seriously ill, their families and ourselves.

You can see Dr. Primomo’s obituary and sign the memorial guest book.

Memorial donations may be made to: UTHSCSA

I want to leave you with a quote from Dr. Primomo's presentation (41:00 of video above)
 Palliative care is greater than palliative care. For me my experience in Palliative care has been the icing on the cake as far as my medical practice and my life. I have found great fulfillment and I see great potential in hospice and palliative care. As palliative care physicians, nurses, social workers, chaplains and even volunteers we have gotten a peek to an aspect of living that we can explore further.  Palliative care is actually service to others and in the service to others is where we find ourselves. We find our spiritual selves; we find our answers to our own questions.  Palliative care in giving good symptom control, in fostering good communication, in good ethical practice and in looking out for the spiritual side of life; can assist us in overcoming the fear of death. And in making death a safe, fulfilling and enriching experience not only for the dying patient and their family but also for the physicians and nurses caring for the patients.

Dr. Primomo in 2007 presenting on spirituality
Dr. Malakoff on the left was the first palliative fellow at UTHSCSA
Dr. Sandra Sanchez-Reilly on the right is the UTHSCSA and VA Palliative Care Fellowship Director

  1. Mary M. Heidbrink, Dr. Primomo pioneered hospice care here San Antonio Express-News : March 8, 2014 accessed March 8,2014 at http://www.mysanantonio.com/obituaries/article/Dr-Primomo-pioneered-hospice-care-here-5298564.php
  2. Marion Primomo MD February 2008 Grand Rounds: The history of palliative care.  Accessed March 8, 2014 at http://youtu.be/ZzLP_XKjJpc
  3. Marion Primomo MD March 2007 Grand Rounds: Spiritual/Existentialism Needs at End of Life http://youtu.be/rHsz_rXBYTA   
  4. Kelly A. Goff. Women Physicians. San Antonio Women magazine May/June 2004 Accessed March 8 2014 at http://www.sawoman.com/women-physicians
  5. Porter Loring obituary  Marion Primomo MD. Accessed March 8, 2014 at http://www.porterloring.com/sitemaker/sites/Porter1/obit.cgi?user=1260662PrimomoMD
  6. Dr. Marion Primomo was given the "Outstanding American by Choice" recognition by the US citizen and immigration service (USCIS) in San Antonio Jun. 22, 2006 http://www.uscis.gov/archive/archive-citizenship/archived-outstanding-americans-choice/2006-outstanding-american-choice-event-photos
  7. Memorial donations may be made to:  http://makelivesbetter.uthscsa.edu/primomo 
  8. Photos  courtesy of  Mark Johnson
  9. Dr. Primomo’s must read suggestions:Man's Search for Meaning by Viktor E. Frankl
    I and Thou by Martin Buber
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