Athena Institute Pre-med Hospice Volunteer Program:
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2013 Hospice Graduates Submit "Reflection Essays"
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Athena Institute believes that this grant and program will help inspire students to choose geriatric medicine as their field, a specialty that is presently underserved. Concluding each year, the program graduates are asked to submit their 'reflections' in essays… we hope you find reading their feedback as rewarding as their own experiences suggest they did. Please scroll down for each student's essay (last names omitted).
Alexis L. -- Swarthmore, Class of 2015
Having had a loved one who has gone through hospice, I was acquainted with hospice before I started this program. Becoming a volunteer for hospice, however, allowed me to view hospice, the people it serves, and the field of health care itself from a very new perspective. Coming into the program, I was eager to help; I wanted to give back to the organization that helped my grandmother and my family in her dying days.I was, of course, nervous about what role I would be able to play in my patients' households. I was somewhat skeptical about how useful I could be in their homes; what could I do for these dying people? What I have realized during my time volunteering with this program is that this perception itself is problematic. Yes, the people I have served are dying, but above all they are people, and to think of them first as anything except human is disrespectful and dehumanizing. I do not fully understand why we otherize people at the end of their lives; perhaps our own fears about death lead us to try to distance ourselves from those nearing death, but what I do understand, or at least believe, is that it is something which we must try to prevent. This is not to say that dying people are exactly like those in good health; the process of dying does indeed rob people of their capabilities, their memories, and this is frightening, but, I believe, these things are only dehumanizing if we give them that power. Regardless of the health of a patient, the patient is a human being first, and it should be the goal of every person, health care provider or not, to view their fellow human beings as such. Thus, over the course of my time as a volunteer I have been able to transform my way of thinking, and now, each week when I go to visit my patient and their family, I am comfortable knowing that I can provide the same companionship and kindness and understanding I could provide to any other human being, and that this is something valuable, for it provides comfort to both my patient and their family.
The program has also allowed me to rethink what it means to be a healthcare provider and provide care to a patient. I believe there is a somewhat common societal view about the field of healthcare that if a physician cannot 'fix' a patient's problem, then the physician has failed and the patient is a lost cause. I do not think I have ever agreed with this perspective, but I am sure that it has had some influence on my views of what services a physician or healthcare program should provide. Being able to spend time with the patients and their families, however, I have been able to see, quite clearly, that healthcare, and our perception of what it can provide to patients and their families, should extend far beyond the administration of medicine by a physician. A patient is never a 'lost cause,' for even if there is nothing that can be done to prevent death, there is always something that can be done to promote the comfort and dignity of a patient, and this care does not necessarily have to come from a physician. There are many ways to promote comfort and health that do not require a medical degree. I have been able to learn this first hand as a volunteer, and as I continue on to medical school, I know I will remember the lessons I have learned; I will remember that patients are not defined solely by their illnesses, that they are people first, with families and friends, and thoughts, fears and desires, and comforts and discomforts. I know the services I will provide to patients as a physician will be different from those I am now providing as a volunteer, but I hope that, regardless of the care that I am providing to patients in the future, I will approach every patient with these invaluable understandings that I have gained as a volunteer.
Aigner P. -- Haverford, Class of 2014
This hospice experience is one that has been too short for me. Because of a lack of flexibility in my schedule I have not had enough time with patients, as I would have liked. However, in the experience I have had, hospice has influenced my understanding of medicine, by influencing my understanding of death.In thinking about being a doctor, in dealing with other people's health, death is something that can happen at any time. Having learned about end stage life, and realizing that the end of life looks different on every person is one of the most profound understandings of medicine I have gotten. It is a reminder that illness will affect different people in different ways. It is also a reminder of the importance of remembering that each patient is an individual with different needs, and that what one patient needs may not be good for a different patient with the same illness.
This realization is one that I feel like many doctors should take more into consideration. It made me think a lot about the kind of doctors my parents do not like; the kinds who pile many patients into a couple of hours, and do not give the time necessary to really asses and be with each individual. I think that being with an individual and being present as a doctor is one of the best ways a doctor can help their patient. Being present is something I learned in hospice, but it is a quality that reaches the people you are interacting with.
It is surprising to me that within medical school and the entire process that goes into becoming a doctor, there is no requirement for any sort of hospice work. It reminds me of an article I read titled When Doctors Grieve by Leeat Granek, which discusses grief of doctors. In thinking about this article it puzzles me that there is no grief training, or work like hospice work, because it is such important and preparative work, especially for doctors who work with high-risk patients. From what I understand about medical school, students are not given any real training on grief and when moved into the professional world, have no exposure to grief, but then are negatively viewed if they express it. I think that doing hospice work has helped me with learning about grief. I was worried that when I started doing hospice, I would not be able to separate my job as a volunteer from whatever connections I made with my patient and their family. I was worried that I would be in serious grief, which is something I constantly worry about when thinking about being a doctor.
However, in the last training, one of the older volunteers said something that stuck with me and really helped me to think about what this hospice volunteering was. She said something along the lines of making sure you are there for the patient, and not there for yourself, because if you are there for yourself, you are being selfish and you will learn anything. That thought really helped me to deal with my own emotions, and be able to approach my patient in a way that afforded them whatever they needed at the time.
Brandon R. -- Haverford, Class of 2014
When I applied to join the ranks of hospice volunteering, I did not know what to expect. Part of me expected to advance toward some sort of emotional or philosophical enlightenment subsequent to forging unique relationships and then watching them dissolve alongside the corporeal condition of those with whom I might have connected. Another part of me assumed that the likelihood of such sentimental experiences was slim; that such Hallmark occurrences would not and probably should not be attainable simply by enlisting in some resume-building extra-curricular commitment.
But the loudest part of my subconscious insisted all the while that regardless of whether l was likely or not to encounter the opportunity for genuine human connection, certainly I would not be capable of seizing that opportunity - of letting something affect me when my entire life I have been trained, just like so many other ambitious youth, to forge through life callous to adversity and steadfast in my self-image, indelibly committed to garnering knowledge and mastering career-oriented skills.
When my uncle died last year following a precipitous decline from historically immaculate health, I was beset not only with confusion as to what I should feel, but more importantly, confusion as to why I was confused. Why shouldn't my emotions have been clearly defined and reflect the standard cocktail of grief-related symptoms that ensue following loss of a loved one? I felt that despite the novelty of the experience for me, I should not have even been able to accommodate this complexity of thought, which should have instead been diluted beyond retrieval by illogical (or, more accurately, un-logical) passions and drowned by involuntary tears. Even now, as I watch my grandfather proceed through an inevitable, though perhaps less abrupt change in reality, I feel strangely removed from the consequences of this shift, as though I have forced myself towards detachment by replacing anachronistic sentiments with more pragmatic considerations of the 'natural order of things'.
From working in hospice, I have gradually come to the realization that like death, enlightenment too will come in its time and place, and that to presume otherwise would be to undermine its value, and render it unworthy of pursuit in the first place. Just like satisfaction, love, and happiness, enlightenment would lose its meaning if we didn't toil on in its absence for significant stretches of our lives. That being said, my variable experiences with patients have in conjunction altered my perspectives on the way I should conduct myself and the way I interpret the worth of my actions to the world that hosts me. Whereas I have been raised to seek, and then satisfy some objective criteria for creating a productive existence for myself, hospice volunteering has led me to acknowledge that one's function in life and influence on the surrounding world is not and cannot be deliberately decided by the intentions of the individual alone, no matter how good or bad, productive or apathetic they may be. In fact, your actions likely have at least as much relevance for the community in which they occur than they have for you. Therefore, even if I do not discover something new about myself in the process of volunteering with hospice services, my presence and engagement can still have an overall positive effect- this effect may just occur somewhere else in the so-called grand scheme. But then, of course perhaps I actually have learned something new about myself.
I am not a particularly religious person, and as a scientific person I find myself constantly confronted with reasons not to place faith in any divine intangible entity. However, if there is a type of faith with which I am comforted to proceed, it is the (albeit blind) faith that with time, and perhaps some degree of well-intended earnestness, life's variables will assort themselves in some acceptable manner. I could not begin to articulate how, yet I could not be more convinced that the sentiment contained in that philosophy, which has matured greatly over the course of volunteering in hospice, will improve the way I conduct myself as a physician in a way that none of my sentiments to this point could have.
Erin C. -- Swarthmore, Class of 2013
Entering into the hospice program, my experience with medicine had been limited to interactions with cell cultures in the laboratory. With a desire to broaden my view of what medicine really means, I joined a program that I hoped would show me new aspects of medical care and patient interaction. What I experienced through the hospice program, although it encompassed these hopes, ended up giving me so much more than I had expected: new perspectives not only on health care and aging, but also on relationships, love, and life.
In this reflection, I focus on my second patient, a fifty-two year old man from Mexico. I was assigned to him because of my Spanish ability, since although he spoke some English, his first language was, of course, Spanish, so it was ideal for him to have someone with whom to communicate. I visited him for almost two months, until he was taken off hospice and went into the hospital. During these months, I visited one afternoon every week, and we simply talked, watched cartoons, or listened to music. He and the family did not have any specific logistical needs in terms of his care, so I was there to simply keep him company and sit with him.
At first, it was a little difficult to communicate; not only were we speaking a language that for me was not my native tongue, but also his tonsil cancer made it difficult (though not painful) for him to speak in a clear voice. His patience, however, was strong; never did he seem annoyed nor upset when I could not understand him, needing to ask “¿Cómo?” - the Spanish was of saying “What?” - two or three times before understanding.
What struck me the most about him - and what I hope will stay with me forever - was his incredible appreciation for life. He had this peace about him. It's hard for me to imagine being so far away from home for so long, so far away from family in a place where I didn't feel entirely welcome, but week after week he welcomed me in and shared stories and happy updates from his life. He told stories from his youth (one in particular about a near-death experience when he was eleven) that he rarely shares with others. But memories were not the only things that brought him light in those days - he was excited and anxious about things like getting a wheelchair so that he could go outside in the days of springtime, excited about the fresh air and the renewed life outside.
Many times, his wife would join us for our conversations and share her own stories and her own dreams for the future, which included moving back to Mexico and becoming a foster parents (she and her husband were unable to have kids). He would look at her with love, nod, and say “Lo vas a lograr.” - “You will achieve it.”
The hospice volunteer program, for me, has not only been a window into patient care (it is, after all, a distillation of the palliative side of medicine), but also has brought me in contact with people with whom I never would have met. I hope to carry this light - the joy, the hope, the patience and appreciation for life - from this patient and his wife with me always.
Diana B. -- Haverford, Class of 2013
I think this hospice program has given me a better understanding of death as a process. Before participating in the program, I hadn't had any substantial experience with the dying and thought of death more as an event. As I learned more about it, however, it became clear to me that the weeks or months preceding it, as well as the time following it, play a key part in the lives of both the patient and their loved ones.
Additionally, being a hospice volunteer certainly pushed me outside of my comfort zone and placed me in positions where I was required to be calm and responsible even in confusing situations. These are important skills to have in any career, but particularly one in medicine.
One of the things I found particularly interesting about hospice is how caretakers and friends act around the sick individual. Some caretakers act as if the person isn't even in the room whereas other acknowledge their presence, but treat them like they have the mental capacity of a small child. For example, caregivers whisper bad words or use unnecessarily high-pitched exaggerated speech. I was always curious about how the patients felt about this, and whether they felt any agency in the situation. My understanding of hospice is that it intends to provide dignity and choice to those who are dying. These aims make a lot of sense to me and I agree with trying to change the way the dying are treated in our society. However, it always struck me how helpless those requiring the service seem to be. I suppose that they would not have any more agency in a hospital setting, but I wonder for whom hospice service really improves life. On one hand, the families that I saw really loved hospice and had great things to say about all the people involved. On the other, they were clearly exhausted from having a person dying in their own home and were eager for any chance to get a break. There is no easy way to handle a loved one dying, but it occurred to me that for some caregivers, the strain of seeing the process happening might be psychologically traumatic and more difficult than beneficial. I have no good answer to the question of how end of life care should work, and I think hospice has the right goals in mind, but it definitely brings a whole new host of issues to the table.
Another part of the program that I found interesting were the reflection meetings. I think these made me think a lot because they changed my perceptions about how other people view death. I was raised without spiritual or religious beliefs of any kind. It was a bit of a struggle for me to grasp what others felt when they talked about the feelings they felt when they read scripture to a patient and I felt anxious during training when we were talking about spirituality and religion. I actually do not feel like that part of the training was done particularly well, because even the definition of spirituality which was provided contained the word “God” and this is not something that encompasses my personal beliefs.
This being said, there was certainly something very touching when I would tell a patient I had to leave and, even if we had only spoke a few words throughout the course of my visit, they would look up and say, "Oh really? Already? Well thank you so much for visiting, it meant a lot.”That feeling helped confirm my desire to work in a profession which directly benefits others. Additionally, it helped confirm my desire to move forward in a medical field involving terminally ill patients. I am more confident that I am able to think about death and consider its repercussions without too great a negative impact on my own well-being.
Sarah B -- Bryn Mawr, Class of 2013
My hospice volunteer experience was bookended beautifully, as it both began and nearly ended with a death, though within two separate contexts. When I went to visit the first patient I was assigned to, I drove through the beautiful, rolling hills of suburban Pennsylvania to arrive at the door of a woman whose husband passed away only that morning.
Though I obviously wasn't supposed to be there, she welcomed me with open arms, insisted that I come into her home where her friends and family were gathered, and told me about her husband. I spoke with her a while, laughing at the stories she told, and smiled when she showed me pictures of her and her husband's adventures as his death from brain cancer quickly approached. When I left the home, her brother walked me to the door , gave me a hug as I apologized for intruding, and said, “Thank you for smiling.” At this point, I learned a very revelatory lesson: in the face of tragedy, little gestures do matter, and in certain situations it is perhaps better to provide warmth through smiles and laughter during remembrance, rather than being forlorn in sympathy.
In January, I met the hospice patient who I regularly visited until last week, a woman who has suffered for nearly a century with multiple sclerosis. At the disease stage of being able to move only her pinkie finger of her left hand, the patient and I peppered many a Friday afternoon with talk of her family, her worries and fears, her hopes, in addition to the latest soap opera and talk show news. Initially, I could tell I was present more for caregiver respite than to keep her company - she seemed agitated at my arrival. After only a couple of weeks, however, her husband told me that she now looked forward to my visits, and would wake up and say “It's Friday! Sarah's coming!”. Over the course of the last few months, we became very close. I was invited over for Easter dinner, and enjoyed meeting her family and putting faces to all of the people within her loving anecdotes.
Over the course of time, I began to relate to her as a family member. For this reason, the past two weeks have been particularly distressing. After spending a week in Bryn Mawr Terrace, during which I brought her banana ice cream (her favorite) and chatted with her and her roommate, my hospice patient took a turn for the worse. Last week, I was over at their home and her husband asked if I would like to say goodbye to her. I entered her room with her husband and daughter, and felt frozen. I didn't know what to do, or how to react, and felt extremely helpless. All I could do was put my hand on her shoulder and close my eyes. I drove away from her house that afternoon extremely upset, feeling like I had just lost a loved one, likely because I had.
I would certainly agree that volunteering with hospice has changed my future practice of medicine, but I think more importantly it really has changed who I am. I have truly realized the importance of listening alone - listening without providing advice, or solutions, or fixing anything. When able to let go of what you can be doing to help someone with a worry or concern, you become gain much more power as listener. I also became acutely aware of small gestures and their importance, not only in learning about how hurt my hospice patient was when her doctor would barely greet her in the hallway at the hospital, but also in doing seemingly small things myself, like learning the names of soap opera characters, asking about her grandchildren, bringing over flowers on Easter day, or unexpectedly supplying my patient's favorite ice cream. I have always been aware of how important it is for people to feel appreciated, but didn't really understand how such small acts of kindness can impact mood, particularly the mood of those who feel like they are being forgotten by the world. Additionally, I feel blessed in having been offered a glimpse of how generous and loving humanity really can be - both in being invited into someone's home during an extremely sensitive time, after the death of a loved one, to seeing how devoted someone can be to someone whom they love, as I saw in the caregiver of my most recent hospice patient. There are so many horrors taking place everyday in our world, but witnessing the strength and compassion of people in the context of hospice has been very profound.
I think I have been most surprised by how emotional this experience has been, and the extent to which I grew to love my most recent patient. I went into hospice thinking that I would be level-headed in the sight of death, that I would enjoy spending time with these people but that they were not my family and their deaths would not upset me to the same extent. However, I realized how quickly bonds can form in such a situation, and I was taken aback by how upsetting my patient's recent decline has been, in addition to how meaningful saying goodbye to her last week was. I have even gone through a period of feeling very angry over the fact that such a lovely human being could be dealt such a bad hand in life, having suffered for nearly 50 years. I recognized in this realization that such challenges will certainly arise in medicine, as I feel that over the course of my career there will be patients who I connect to on the level of my past hospice patient and feel a very strong attachment to, those who are sick and might not ever get better. At least after this experience I will be less blindsided.
I will take all of these heartening lessons with me, and am so incredibly grateful for the opportunity to become involved in not only this hospice program, but the lives of others.
Fateema E. -- Bryn Mawr, Class of 2014
Having had very little experience with even the idea of hospice care, I now have a better understanding simply of what it is and what services are involved. This experience as a hospice volunteer has also provided me with insight to the difficulties of end-of-life care. In addition, I now truly have an appreciation for this alternative option for patients.
To an outsider, the word hospice is automatically associated with grief and sadness, but I have been surprised by the contrast between patients' opinions of hospice care versus end-of-life care in a hospital. My patient felt very strongly about never spending and extended period of time in a hospital ever again. However, I do hope that the some of the positive aspects of hospice care can eventually be transferred to the hospital experience. I was also surprised by the wide range of patients that are on hospice; how they vary in age, illness, alertness, etc.
Hospice volunteer training and my hospice volunteer experience have certainly had an impact on the way I view medicine and the role of the physician. One of the core values of hospice care that I think can be applied to medicine as a whole is the idea that the needs of the patient are the most important. As a future physician I will remember that my purpose is not simply to heal, but also to serve the patient. The emotional needs and comfort of the patient should be a focus in addition to the diagnosis. This experience has also opened my eyes to the importance of simply being there for others and that there is no “typical experience.” Reflection sessions with other students were very helpful in gaining more insight to hospice care. However, it was difficult to not feel like our experiences were unconsciously being compared. My patient was in pain but very alert and often seemed frustrated by her situation. I came to accept the fact she was not always interested in my company, especially as I may have been a reminder of the fact that she was on hospice care.While this was not the patient connection that I had imagined was part of the hospice volunteering experience, the gratitude of her caregiver for the few hours of respite I could provide reminded me that I was still helping someone. The need for any caregiver, whether a relative or hired, for a break or a chance to run errands is a reality of hospice care. I realized that as a hospice volunteer it was my duty to continue helping these women, no matter how mundane or simple it appeared to someone else. For me to ask for another opportunity, seemed like an expression of the idea that helping them was not worth my time. I think this will apply to my future as a physician in that it has reminded me that although my relationships and interactions with patients are bound to vary, each patient is equally deserving of my time and care.
Ted G. -- Swarthmore, Class of 2014
These past few months I have spent in the Hospice program have truly been an invaluable experience for my personal edification. I hope that my volunteering has served as a relief-providing assistance for the patient and family I have visited, rather than an inconvenience.
As a current Premed student (and potential future doctor), I truly appreciate my work in Hospice. In my opinion, I believe that the often difficult, required classes that a premed student must take, like organic chemistry, diverts the student away from the necessary “emotional” training that a future doctor must attain. Sure, these classes “weed out” academically undisciplined students, but that is their only role.
In essence, these classes generate negative personas (i.e. competitiveness, self-centeredness, etc.). I feel that a certain level of maturity and even wisdom should be required in the “premed track” - the Hospice experience has definitely helped me in this way.
I feel blessed with the opportunity to (cautiously) enter one's home and provide any form of assistance to the primary caregiver. Oddly, I cannot envision most doctors partaking in this type of work. From my past shadowing experience, I have felt that the hospital setting is like a big corporate marketplace: the staff puts forth their best effort to serve their clientele in order to promote their own status in the “medical hierarchy.”This idea seems very dark, but for an on-call hospitalist or internist doctor with 20+ patients on his/her plate a day, devout attention and care for a single patient is difficult and challenging to demonstrate. Thus, I emphasize for these doctors with this overwhelming burden. I hope this aspect of the health care system will change someday.
I have learned so much about myself through my volunteering in Hospice. I have realized how awkward and immature I was before this experience. I consider myself inexperienced and uncomfortable when dealing with the concept of death. I still feel uneasy about this topic, especially when I am in a room with an actively dying patient that I know just has a few weeks to live. I am still surprised how courteous the family I visited was, allowing me to take part in this sacred process.
During training, I believed that students were often able to talk to their patients and develop a deep, personal relationship with them. However, I provided more of a respite-type role for the primary caregiver; my patient was mostly unresponsive during my visits. All I could really do was pray by his bedside. Future students should not expect to always have social visits. But, just because one's work does not involve social interaction does not mean it is unimportant or unhelpful. One's mere presence can at times prove sufficient.I thank Michele Whipple for her dedication to helping TriCo students become involved in this wonderful opportunity to sincerely help others in a unique way many of our peers are unable to experience.
Yvonne S. -- Swarthmore, Class of 2013
On my first day with my Hospice patient, I walked into the room and she immediately flew into a tizzy. I was new, I wasn't qualified, I didn't know her medication schedule-I basically couldn't be trusted to be left alone in caring for her. On one level I completely agreed with her; the first two statements were undeniably true.
This was my second ever Hospice visit, and I had virtually no training in the medial side of palliative care other than having a pretty good academic sense of what the words meant. What I was able to pinpoint in that moment though, was that it does not logically follow that I couldn't be trusted with the role I was being asked to play. I certainly wasn't ready to give her any medical advice, but I firmly believed (and still do) that she could teach me everything I needed to know about how to be there with her for two hours.
Instead of feeding off that frantic energy by emulating it, I could read that frenzy as a call for calmness. She was communicating that she was anxious and needed reassurance, and I needed to look for ways I could provide that. Though I did not have the formal training she was initially seeking in me, I was not there to be her doctor for two hours. I was there to be her caregiver, and that leveled me with the most academically expert doctor in the world. That expert doctor might know exactly how to treat her, but we were on the same page when it came to caring for her. Both of us have had experience reaching out to other people, and neither of us knew how to modify that experience to accommodate her specifically. Both of us would be in a position of needing to listen and learn. I was able, over the course of that visit and the many to follow, to learn about her. She trained me to recognize what she liked and didn't, what made her content or uncomfortable, and what I could do to encourage comfort and content from our interactions.
I think there is something broken in the medical system if a patient's first response to a caregiver defaults to the way my patient first responded to me. Yes, doctors should have expertise that extends miles beyond what I brought into the room, but that ample expertise should not stop them from entering the room themselves. The fact that this experience was with end of life care takes medical treatment even more out of the mix. Doctors should not be limited to the reaches of their ability to treat medically, but use it to expand on an already vast foundation of interpersonal relation and caring. I would hope that when treatment is taken out of the question, a doctor's relationship with and interest in a patient barely changes at all-it started with and continues to be about relating to and caring for the person in front of you. The fact that my patient reacted to me as she did suggests to me that this was not the type of relationship she had experienced thus far in her medical care.
I think the ability to care for someone is an incredible skill. After participating in this program, I am more convinced than ever that it is one that so many of us can further foster in ourselves, and that all doctors must not only foster but master. Not master in the sense of knowing the end result, but in becoming intimately familiar and expert with the process. The question of how to really listen to patients and respond to them instead of their symptoms is one that I am still exploring, and always will. It is, in fact, I think an unanswerable question, as its answer will start anew with every new patient. And that is my takeaway: that patients can best teach caregivers how to care for them. I am grateful to have been gifted that clarity, confidence and, hopefully, humility when approaching anyone I may treat as a Hospice volunteer or future physician.
Maura F. -- Bryn Mawr, Class of 2013
My experiences with Hospice have shaped me in a variety of ways and will be carried with me as I continue my journey to become a physician. After spending the time training to become a Hospice volunteer, I was unsure of what to expect from the experience, but as quickly as after my first visit I knew this was going to be an experience I would learn from
In the time I've been a volunteer for Hospice, I have connected with patients and learned valuable things about myself from my interactions with them. A major aspect of this experience has been learning how to communicate with patients approaching the end of the lives. I feel it is essential that physicians have the ability to comfort and care for patients even after life-extending treatment has ended. Hospice has taught me that it is important for physicians to be available for their patients during all stages of a patient's illness. By building relationships and caring for the needs of Hospice patients in the present, I hope I will become a more caring and compassionate physician in the future.
As far as questions that have been answered, I feel like the main questions I had going into this was the uncertainty of my ability to be able to interact with people in serious pain and near death. I had never been in situations like this before, but this program has given me the confidence to face new situations and know that I can handle them when given the proper training and having the right mindset about the situation. I tried to not think about the gravity of each patient's physical state when I went to visit the patients and instead I focused on them as people and tried to get to know them as best I could. I liked to hear stories about their lives, their families, and their greatest accomplishments and regrets. Questions that have been raised to me through this experience greatly involve the finality of death and what comes after. Everyone has different opinions about the matter, but forming relationships with patients and then having them pass away has made me question the process of death much more than I expected.
The aspect of this experience that surprised me the most was how little I talked about death with the patients I visited. Rarely ever did the topic come up and the conversations mostly focused on the patient's life experiences.As my visits increased with a particular patient, the pain they experienced would increase and that was something that was difficult to deal with. It's hard when you are not qualified to do anything to diminish their pain, but all you want to do is help make them feel better. Another surprise was how close I became to the caregivers. I truly felt their gratitude towards my visits and that made me feel even better about the experience. Not only was I helping the patient, but I was also helping their loved ones. All of these encounters helped influence my perspective on the end of life experience and I will cherish the memories I shared with these families forever. I am very grateful to Hospice for giving me the opportunity to share experiences with their patients and learn more about myself as a person in the process.
Kate D. -- Haverford, Class of 2014
I feel that my time spent volunteering for hospice has been one of the most meaningful and eye-opening experiences of my life. Truthfully I was very nervous to visit my patients and their families, mainly because I thought that interacting with people at such a fragile and emotionally charged time in their loved one's life would be overwhelming.When friends asked me what my volunteer work would entail, almost every one of them commented on how depressing the experience would be. To my surprise, I found my hospice work to be anything but depressing. Although saddening at times, overall I found my presence at the end of my patients' lives to be a serene and profound experience. I was fortunate enough to be asked by one of my patient's families to be present very near to the end of my patient's life. He passed in his own bed, in the house he in which he had built a full life, surrounded by loving family members. There were no beeping machines, no doctors pushing loved ones out of the way to try some last-ditch attempt at resuscitation. It was calm, peaceful, heartbreaking and beautiful.My perception of what it means to be at the end of life has been drastically changed by my hospice volunteer experiences. My biggest question coming into hospice was how the patients and families would cope with the impending end of life. Given that everyone processes grief differently, I was unsure how I would handle the wide range of emotions and reactions that patients and family members would have. Through my volunteer work I learned that the best and most helpful thing a person can do is be a good listener. While volunteering for hospice I encountered a range of reactions to my presence, from gratefulness to anger to confusion. In each situation, I found that the best I could do was listen to the concerns and needs of my patient, and tell them honestly if there was anything I could do to help. In the beginning it was difficult for me to admit when things were outside of my volunteer authorization, such as administering medication or buying things for my patients, because I felt like I was letting my patients down (don't worry I refused!). This is another lesson I hope to carry with me as a physician; the ability to admit when things are outside my realm of expertise.
Before joining the hospice volunteer program, I had always had a great deal of respect for and belief in hospice's philosophy of care. I believe that, in our modern medical mindset, death is treated as a symptom to be avoided, rather than an inevitable outcome. Hospice's philosophy of care accounts for the inevitability of death, and focuses on truly allowing patients to live in the best comfort possible for the remainder of their time. While hospice focuses on caring for patients, rather than curing them, during the final stages of their lives, I believe that the same level of attention should extend to all patients, regardless of their prognosis. I think this is the biggest lesson I've learned from hospice; when I ask my patients how they are, I am going to mean it in every sense of the word. I want my patients to know that I view them not as a list of symptoms, but as an individual with needs that extend far beyond what a thermometer or a blood pressure cuff can tell me. Hospice has taught me that, as a physician, providing true patient care is so much more than finding a cure.
Sruthi B -- Bryn Mawr, Class of 2015:
The Reflection Paper and the final meeting will focus on the following questions:
1. How has the Hospice experience affected your understanding of medicine and your future as a doctor?
2. What questions have been answered for you? And what questions have been raised?
3. What surprised you or perhaps even changed some of your thinking or perceptions?
Visiting multiple patients, visiting one patient, in multiple sites - private homes to nursing home
All the places I've been:
Cathedral village, Wayne, Strafford
My understanding of medicine -
Before: treating patients, helping patients to get better, to heal physically
After: allowing patients to just be, to offer pain relief but to also allow them to transition gracefully into the next stage of their journey after death
My interactions with my patients have been varied, but a similar pattern between all of them have emerged - the necessity and the beauty of just being there, of saying “I'm here for you, here now and I want to keep you company, I want to care for you” and their reciprocated thanks in the forms of kindness, respect, and utmost generosity.
I have become more sensitive, more careful and cautious in my interactions with others, more respectful and more kind. The wisdom that many of my patients have shared with me has been phenomenal. In reading prayers and stories, in talking with them and in sitting beside them in silence. I have acquired an immense respect for the elderly, they are precious treasures and have so much to offer each one of us in their teachings of kindness and generosity, wisdom, and healing from the hurts of the past.
This program has acquainted me with the physiological, emotional, and psychological aspects of death. Having never before personally dealt with or experienced deathI have a distinct admiration for the elderly and found that spending time with them has imparted to me wisdom, compassion, an appreciation for humanity, and a respect for life. After witnessing the death of loved ones in my life, I realized how little I know of mortality and how little I know to confront it in my future path. I am aware that although this program may be difficult for me emotionally at times, I will grow tremendously and will extend the wisdom and development I experience to all aspects of my life - especially as a caretaker.
I hope to volunteer my time and efforts in interacting with patients, reflect on mortality, and pursue development as the caretaker I would like to be - someone who is sensitive, responsible, and intensely compassionate.My initial interest in participating in this program was sparked by my distinct admiration for the elderly, my awareness that I had very little knowledge or experience with death and hospice care, and my desire to extend the wisdom and development I experience through this program to all aspects of my life. I wished to volunteer my time in interacting with patients and pursue development as the caretaker I would like to be - someone who is sensitive, responsible, and compassionate. After eight months on this journey, I have grown immensely beyond comprehension in each of the above areas.
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