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Athena Institute Pre-med Hospice Volunteer Program:
2014 Hospice Graduates Submit "Reflection Essays"

Read essays from 2015
Read essays from 2013


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).

 

Lauren S.  (Haverford College)


Through my experience volunteering with Holisticare Hospice, I have been able to assist individuals nearing the end of their lives by creating an atmosphere of community, reliability, and respect. I believe that these values are important in guiding my daily actions and interactions with others, including patients and their families.

The first patient I met was nearly deaf, confined to her bed, and had very few visitors. With twice-weekly visits, I became a calming and reliable presence in her life. Due to her condition, verbal communication was nearly impossible and therefore, I engaged her attention with fashion magazines after learning that she was once a seamstress.

Over time, we developed a mutual understanding where I would turn the pages until she nodded for me to stop, so that she could admire the colorful pictures. I also checked in with her nurse and social worker on a regular basis, and became a part of her support network during a time of uncertainty and confusion. While I was initially a complete stranger, we were able to foster a unique and respectful friendship that helped her maintain a sense of serenity and ease before she passed away.  

 
The process in its entirety was difficult—meeting people I knew might not be alive the next time I planned to visit was hard to digest. My time with them seemed almost surreal, but at the same time, it was incredibly fulfilling. It is truly amazing how human connections can lift our spirits and I saw that firsthand with the patients I worked with. I am so grateful for this experience because I have learned the value of just being in the same space as someone else and how reassuring that presence can be.

Tara Y. (Bryn Mawr College)

A year ago, I came across the new word “hospice”, which is not a common word people talk about in our school life. Even its Chinese translation, "end of life care”, is hardly mentioned in newspaper, hospital or internet of my past twenty more years of life. I have  dealt with two deaths of my grandparents in last three years, and this word was tragically new for me.


I remembered sitting besides my dear grandma a week before she passed away, and I kissed her forehead. She was already in a half confused stage, but I think she felt my kiss we don’t kiss between family members or friends before our generation. I talked to her in the sweetest voice when other relatives are not around, and I slept by her side the last night before she was gone, constantly waking up to check if she wanted something. My actions were quite strange in my relative’s eyes, as “proceeding to death” is such a forbidden but unavoidable notion. They didn’t want their children staying around my grandma, and they didn’t talk about their feelings to grandma or others. The next day, I left for my flight back to the US when my parents told me she was gone, so I didn’t get to participate the traditional funeral where people are required to cry as loud as they could to show their sadness over someone’s death. I feel that I was doing the right way, not my relatives. I respect the traditional culture of my country and my family I think my grandma expect that as well but I could see her pain and helplessness lying in bed, facing the killer cancer lonely. My dad expressed his love to my grandma as I did, making only two of us in our huge kin who actually farewelled to her. I didn’t know the missing part of all these until I saw the word “hospice”.

We had a few lectures before we started our hospice volunteer job. First of all, hospice is for the person at his or her end of life, being comfortable and being able to achieve some wishes if possible. Secondly, its about the caregivers, the family and friends, who also need to find a right way to grieve and to help. The core to achieve these two goals is the availability of professional support and tactful but clear communications among all parts. Being a volunteer gave me the opportunity to understand “my feeling that something was not right ” of my grandma’s passing away, and to think about the missing part in our society for end of life guidance. Economically speaking, hospice is also a beneficial service for saving hospital resources and cutting extra costs. Translating my personal experience into a bigger picture as a future doctor or public policy analyzer is the most rewarding outcome of my time with hospice program.

Another important, and probably the most important experience is visiting my patient. This is the most direct exposure we as volunteer get, and I feel wonderful in the process. My patient expect me to visit not so frequently, so I tell her my recent adventures while she analyze a bit of the changing weather.(smile) She has aphasia, but I can still understand her when she uses  wrong words. I am extremely excited every time I walk into her room and she recognize me. Being able to sit by her side and listen to some small complaints, from certain aspect for me, is to, make up for what I didn’t do with my dear grandparents, and to relate that love to someone I just met. The realization of this is a critical emotional and rational process of being a “public caregiver “, like a doctor, public health analyzer, NGO leader, government officials, etc. Public service is no longer to our beloved ones, but to anyone fairly. I feel lucky that my patient is there to teach me this, and I am grateful that I can provide my service to her, making her happier. The idea that people can face their own death or loved one’s death in a more comfortable way is what hospice grants us.

One time I was just leaving the terrace my patient resides in when her friend was taking her to lunch. I heard a sentence she said about me: “She is really nice.” “Indeed she is,” said her friend. I stood at the door, couldn’t help smiling.

Sara L.  (Haverford College)

I think a lot of times when people ask you how an experience has affected you they expect some profound answer.  They expect you to say “it has change me and influenced me in more ways than I could have possibly imagined, and given me a gift so generous that words do it no justice .”  The reality is that in my time working with patients under the care of Holistcare Hospice I have seen and experienced just about everything I expected to, and I am content and happy to say that my past experiences had prepared me for all of that.


It is with all of that in mind, that I can say visiting with Eddie and Claire over the course of this past academic year has been an honor and a treat.  They brought warmth and a sense of companionship to the table that I had never experienced.  It was interesting that our conversations were never really about anything in particular, but always wound up at the same point—that being to seize every opportunity and live it to the fullest with no regrets.  With all of the hustle and bustle of my senior year in college the two of them reminded me it was okay and even necessary to slow down some times and Claire even mentioned once or twice to me that she was happy she could be that break (…in between making frantic phone calls to every contact in her phone book in an effort to track down the most talented, most praised and trusted hairstylist to give her a more than well overdue perm, of course). 

I have thought about medicine in many ways, but her I was able to see and hear complaints and short comings.  I learned from Claire what she did and did not like about her aids and say categorically what I thought was correct and incorrect.  I can honestly say though that most of the aids that I encountered were saints.  They were some of the most kind, engaging, friendly and caring people I have ever met—people I will definitely aspire to be like as I pursue a career in medicine.  Most of the aids that I interacted with don’t just do their duties but go above and beyond their job description because they truly care about their patients.  It even seems that in some respects they become part of each others family ( if the patient is alert). 

Over all this experience has further inspired me to continue on my current path. It has inspired me to aspire to be as invested and as caring as many of the Holisticare workers, and It has shown me that slowing down and resisting the urge to rush through things has great worth and is exponentially important to reflection and health, and finally it has confirmed for me that very few people are afraid of dying, but rather they are afraid of discomfort and afraid of dying a alone.  Giving these people time out of my day, despite the fact that I know that Eddie and Claire both have people that care deeply for them, showed that that even some random girl could enjoy sitting and talking to them—hearing about their life tails. 

Martha W. (Swarthmore College)

I was inspired to pursue volunteer work in a hospice setting by my desire to broaden my perspectives and understanding of medicine. In my coursework and experiences shadowing and volunteering in a variety of medical settings, I had witnessed the process of logical thinking and deductive reasoning required to treat patients. But I had yet to see the emotional side of medicine that drove me to pursue career in the field in the first place. I believe that my experience in the hospice was able to show me how comforting patients and providing emotional support can be just as important if not more so than providing traditional medical treatment.

Most importantly, it caused me to reevaluate my notions of what the goals of medicine are and what my goals as a future physician should be. Like many people, I believed that the sole goal of medicine should be to do whatever it takes to keep the patient alive. But after speaking with patients in  the hospice, I realized that while medicine should certainly strive to save lives, it should also focus on keeping the patient happy and comfortable and treat the patient as a whole  instead of as a problem to fix. This experience also confirmed and reinforced my desire to become a physician.

I am reminded of a quotation by the French philosopher and writer Albert Camus, who remarked that “Truth, like light, blinds. Falsehood, on the other hand, is a beautiful twilight, that enhances every object.” In my time volunteering at the hospice, I believe I have faced the blinding nature of truth –seeing patients die and experiencing loss is an extremely difficult and jarring experience. Indeed, I was shocked when I discovered two of the patients I had seen during the first semester had passed away during my winter break. But instead of hiding in the beautiful twilight of falsehood and ignoring these difficulties, I have realized that it is important to face reality and the truth as it is and experience these hardships as a physician if it means I have the chance to treat a patient and make them happier and more comfortable.

Luke N.

I have been very fortunate over the last semester to volunteer in hospice through Penn Wissahickon Hospice and receive support and guidance through both Student Hospice Organization of Penn (SHOOP) and the Pre-med Hospice Volunteer Program. Before volunteering in hospice, I had always believed that keeping patients alive at any cost was the goal of medicine. I used to be so confused when adults made comments like "It's okay; she was suffering" after delivering the news of a lost loved one, as if the suffering of the lost relative was somehow worse than death. I honestly could not comprehend the idea of a "Do Not Resuscitate" form, as I believed death to be the worst phase of life, something devoid of meaning, something that should never be seen or spoken of.

When I decided to volunteer in hospice, I thought I would be having life-changing conversations every week with the patients I would work with, adding a clearly visible value to their life as well as to my life. To be honest, a lot of this perception came from watching the movie, Tuesdays with Morrie. However, after meeting and talking to many hospice patients, I realized that many of my ideas about medicine, hospice, and even life, were totally wrong.

Expecting deep conversations, it was a shock to me that most of my patients were no longer able to verbally communicate. I felt helpless in my ability to add value to their lives, but certainly not as helpless as they felt being unable to respond to my futile questions. After my first visit, I came home dejected; I didn't feel like I contributed anything to my assigned patients' lives, and I felt like I gained very little from the experience. However, I went back for my second visit, determined to improve my communication skills, and the results were amazing. I noticed that my patients often had other ways of communicating, whether or not they were deliberate. In this sense, I learned a lot about body language as well as natural human instincts, and I was able to get through to my patients much more effectively.

I quickly realized that the conversations that I couldn't hear were just as important as the ones I could hear. It dawned upon me that medicine doesn't have to be about putting these patients through more pain for a small chance to live a couple more months.  Medicine should be about maximizing the quality of life at any and all stages of life. Just like you or me, these patients deserve to have dignity in every phase of their life, including death. As such, not talking about death only increases the fear of its certainty. Though I certainly enjoy living, I have learned to accept death as a part of life like any other, and as a consequence, I believe that providing for patients in the dying process is just as important as providing for patients for whom death may not be so near. Though I am not sure whether hospice is the right field for my future career, I have certainly learned a great deal that will help me no matter what I decide to do.

Brenda W. (Swarthmore College)

She told me excitedly, “They said I can go home. I’m going home soon. I’m going to go home and finally cook again!” I smiled and nodded in agreement, but knew full well that 'Ms. Carlino' was here to stay. The hospice was her permanent home away from home.

As an aspiring doctor, I’ve been fortunate to interact with and learn from the doctors of today. However, during my interactions with them, I’ve come to realize that I’ve always been sheltered from the “other” side of medicine – the side in which treatment fails and hope is lost. I’ve always wondered what happens to patients who are told they have a limited time left on this Earth – those who have been metaphorically stamped with an expiration date on their decaying bodies. As a hopeful doctor of tomorrow, I needed answers to these questions. This is why I chose to volunteer with Care Alternatives Hospice.

I quickly learned that oftentimes success in medicine is measured by the number of lives and anything less is failure. And, to a certain extent, it makes sense; people go to hospitals and seek doctors to emerge healthier after treatment. But treatment doesn’t always work and I was happy to learn that an increasing number of care facilities were opening up across the United States to provide palliative care to those with whom treatment had failed.

During my time with Care Alternatives, I was fortunate to meet many interesting individuals each with their unique personalities. Ms. Carlino was always the most excited to see us. She would always tell us to make ourselves at home. She was also always the most hopeful about her situation. Ms. Toor was the intellectual and historian who always spoke about her past, but simultaneously cursed her weakening memory. And finally there was Ms. DiMonte, the 99-year old who would always be staring out the window waiting for her daughter to make her daily visits. Every week each of these individuals would have their own stories and their own pains – whether it may be due to illness or because a family member neglected to visit one day. Visits with them taught me the importance of recognizing that humans are extremely dynamic and that, although we live in the constant routine of daily life, we all have our daily ups and downs, moments of happiness and bouts of sorrow. It made me realize that, as a doctor, each and every day would bring a new set of patients with their own unique personalities and challenges that I would need to handle.

My time at Care Alternatives made me realize that hope is the single most powerful thing you can provide to an individual. When you give hope, you give that individual reason to look forward to the future. That hope is even more important to those who are suffering from mental or physical illnesses, because it allows them to overcome tough times. However, from an ethical standpoint, it concerned me that many times patients would receive hope that would never be realized. Ms. Carlino, for example, would always yearn for home and would mistakenly think that she would be going home soon, and I was never able to tell her otherwise. I’m still not quite sure if it was right to never inform her that she would not be going home, but the smile on her face when she thought about her home was so bright that I figured her hope – even if it was false – was helping her get through tough times. And that’s what really matters.

Jessica H. (University of Pennsylvania)

My work with Hospice has been a transformative experience. Before the Hospice training, my perceptions of death, sickness, and how to care for people were very different than after the trainings. I was an individual who avoided talking about death, and never wanted to fathom the idea of a close family member or friend dying, let alone my own death. However, this past year I decided that it was important for me to steer outside of my traditional comfort zone. After deciding to attend a Hospice informational session, I realized that this program combines many facets that I feel not only passionate about but that would also challenge my way of thinking. The program so far has proved to be a personal journey on multiple levels, especially emotional. The Hospice program has come to define my experience with the Philadelphia community but also the way I approach the subject of death.


This past semester at Penn has been very difficult for the campus as all members of the community were confronted with deaths and suicides of fellow students. One of my friends knew one of the students and reached out to me to discuss his struggle coping with the death. Though talking with him was still challenging, as it is a difficult subject to approach, I felt slightly more at ease with the topic because of the training with Hospice. During the training I learned the importance of active listening. Additionally, each person goes through a different struggle and one person can never truly understand what another person is experiencing. Furthermore, you cannot rush someone’s individual mourning process, and encourage him or her to look at the “bright side,” or tell them that there is still so much to be grateful for despite the death. These were concepts that I had not thought about previously and helped me when talking with my friend. The Hospice trainings were not only informational, but also extremely helpful when thinking about my life.

When I first started, volunteering was extremely difficult, as many of the patients I visited could not communicate. This experience challenged me on an emotional level, as I always wondered if my presence was helping the individuals I visited. Any time one of the patients would even acknowledge or attempt to answer a question I was thrilled. Those moments were the ones that kept me going back week after week. 

Penn Hospice has fueled my desire and drive to pursue a career in medicine. Before, this program I had not interacted with patients, let alone consistently visited a medical setting. My interactions with the nurses and my patient have been positive and I cannot imagine myself in a career outside of this area. One of the most touching experiences I have had with the program was the change and progress I saw in one woman. For two weeks I visited her without any response. I would often sit with her and sometimes talk, but more than anything hope that my presence was enough. The third week I saw her she was sitting in bed and looked a lot healthier. Though she could only grunt or nod in affirmation or negation I felt like I could actually get to know who she is. That is one experience I will never forget, and also the one that helped me realize why I want to become a doctor. Seeing the change and improvement one individual can make over time is incredible and truly moving. It was a moment that inspired hope in me that any individual has the potential to progress to a better state no matter what their conditions.

Nicole R. (Bryn Mawr College)

Over the past few months, I’ve had the honor of volunteering for Holisticare Hospice. Before becoming a volunteer, I was not sure how I would be able to handle death. I knew it would be difficult and it would get emotional at times, but it never occurred to me that death could be a good thing. By spending time with the Hospice patients, I enjoyed being compassionate and being vulnerable. I quickly became attached to the residents and appreciated spending time with them.

My experience with Hospice patients has greatly changed my understanding of medicine, especially with regards to the study of healing.

Medicine can help reduce pain and treat disease, but it cannot provide the kind of healing that comes through touch and interaction with people. Medicine overlooks the importance of presence. By simply being there for someone, you are already making a great difference. I learned that there is great value in making space for a meaningful death.

Throughout this process, I’ve admired the elderly men and women that I got to meet at Freedom Village, which is where I went for all my Hospice visits. Each and every one of them had such a unique story and came from diverse backgrounds. I was surprised to see that despite the physical pain, many of them still had so much personality and life to them. My patient had a beautiful smile and was extremely charming. She was a favorite among the nurses, and I could see why. Furthermore, after listening to many patients’ stories, I thought it was particularly touching to see how much their partners had meant to them throughout their lives. Many of them had husband and wives who had already passed away, yet they constantly thought of them.

Hoping to pursue a future career in medicine, I believe my time spent volunteering at Hospice has given me the opportunity to connect with patients at a more personal level. I think it is crucial to understand that there are different ways in managing pain. Being able to open up dialogue about death with patients is something that more doctors should be educated on. Hospice reminds me that part of being a doctor is also understanding the spiritual needs of a patient and their family.

Overall, I came into Hospice in hopes to learn and understand alternative ways of caring that do not always fall into the categories of biomedicine. Death had been something I was not only afraid of but also felt uncomfortable with when speaking about it. This experience has taught me to appreciate time with my own loved ones and be more open in talking about death with them. I have come to understand grieving as a process, and have been able to reflect on deaths that have occurred within my family. Lastly, Hospice has nurtured my respect for the elderly. I will always be thankful for the opportunity Hospice has given me to not only self reflect but meet so many wonderful people.  Each visit allowed me to take focus on special moments and appreciate what both life and death has to offer. Time slowed down in these moments for me, and the beauty of life and death became one.

Hannah  N. (Bryn Mawr College)

After losing both my parents and sister at the age of 8, and seeing my mother struggle at the end of life with no one, but my uncle to care for her, I grew up regretting not being by her side as she walked in the valley of the shadow of death. Keeping in mind my own experience motivated me to begin volunteer work with hospice. I felt a strong urge to care for the dying, be an ear to listen and a hand to hold on to.  

The end of life is a very important and special period for a patient, their family and friends. During our training, we were asked to list goals, possessions, and people who are very special in our lives; we had to give up one at a time until we remained with only one person. To her/him, we had to write a letter at the time of our death. This was a hard and very emotional task to do. Although death is a painful moment for those left behind, I now understand that it is even more scary and painful for the dying. In that moment, they have to acknowledge their impending loss of goals, possessions, abilities, persons. It made me realize how hard it is to accept the loss of everything, of self, and still look forward even with no certainty of what comes after death. Before being part of the hospice program, I was not yet ready to pursue these questions, but working with hospice has familiarized me and made me more comfortable  having conversations of mortality.

In the event that a patient is the only one surviving in their family, there will be hardly anyone to visit them. The only connections they have to their loved ones are photos, gifts and memories. In most cases, patients question why they had to be the ones to die, but one of my patients was questioning why she was still alive. At the age of 101, with the exception of one sister, she is the only surviving member in her family. She feels that she is ready to die but is also grateful for the life she still has; she taught me to embrace life and death when it comes.

One disturbing moment I had during my hospice visits was patient neglect by nurse aids. Sometimes, with staffing shortages at facilities, a few nurses have to care for many patients at a time. Since hospice patients need a lot of attention, failure to respond in a timely fashion makes their end of life harder. This made me realize how important caregiving is in health facilities. It also made me appreciate the work that most nurses put in caring for the dying.  

The biggest lesson I learned is that the end of life is a very important period in one’s life and every individual deserves all the care and support they need. I also learnt that not all situations in life require fighting for; sometimes people choose quality of life with loved ones over battling ailments with aggressive treatment. I am very passionate about palliative care but after experiencing hospice care, and as a prospective medical student, I am now convinced that the work of a medical practitioner should not start and end in the theater - that in my opinion is a reactive approach. Rather, a total and proactive response is needed and that begins with dedicating time to care for the dying. One of the most important skills I learned from this experience was to be an active and patient listener. The training we got prior to the patient visits also significantly prepared us to handle loss, to effectively communicate with patients regardless of any barrier. This experience with hospice has significantly prepared me for my future work as a doctor.  

Jenny M (Bryn Mawr College)

The summer before I began volunteering, I shadowed a passionate cancer surgeon who had interacted with her patients in a meaningful and true fashion. Her professional and genuine relations with her cancer patients left a deep impression on me. Before college, an unexpected death interrupted our family, and left my mother with no outlet for her sorrow and stress. At the time, we were not knowledgeable on how to discuss or deal with death, and so the event changed our family dynamic. I wanted to have a better understanding about how families can discuss death in an open and structured way without being fearful or embarrassed. These personal experiences influenced my decision to apply to the Holisticare Hospice Program in the fall.


Hospice work has redefined and challenged my understanding of human interaction. You are interacting with patients while silently being present with them. Although the patient may not be aware of your physical company, you are aware of it. The awareness has a powerful effect because you are happy and grateful that you were with the patient at a vulnerable time in their life. Personally, this perspective has created more intimate and meaningful visits because I completely devote my time to my patient. 

The reflection meetings have helped me develop my own perspective and understanding of death. Growing up it had been a forbidden topic. Starting out, I was nervous on how I thought I would deal with my own emotions, especially for someone who is empathetic and sensitive. Our open discussions on how we feel when our patient passes revealed that, like anything new you try, you just take the first step. I believe that now I am comfortable initiating a conversation with my family, and with others, no matter what their comfort level is. 
I have learned from my experience, with Hospice patients in this program, that medicine cannot cure everything. When a person’s journey has reached a certain point, it is effective and valuable to have these supportive communities and facilities. I think that hospice is flexible, specialized, and helpful, but unfortunately, it has a negative connotation associated with it. Hospice is still part of medicine, because patients are cared for, and similar to the work of a physician, volunteers, nurses, and family members work as a team to try to relieve the patient’s pain with simple methods like massages and listening to music. In my future career, I hope to successfully share this message.
From my experience I have come to accept death as a natural event, and value the challenging role the hospice team holds in a patient’s and family’s journey. I think that physicians should play a stronger role in caring for the dying, and that we should improve medical education such that future physicians who interact with terminal patients or the family’s of patients who have passed are supportive, empathetic, and are able to initiate these difficult conversations.

My meaningful experience has reinforced my long-term passion to care and help people. I believe that in whatever career path I follow I will continue to deeply value hospice. 

Ben M. (Haverford College)

Hospice care has been the single largest influence on my senior year and, ostensibly, what I plan to do with the next five years as well.  Coming into senior year, I fully believed that I was going to be a physician.  I thought I had my life planned out.  I would graduate from Haverford, take a couple years to work in a lab or work in a more clinical setting, and then I would go to medical school where I would study to become the specific doctor of my choosing.  But, volunteering through Holisticare Hospice at the Exton Senior Living Center has radically changed my career plans, as my thoughts towards medicine, and my thoughts towards public health and public policy. 


Volunteering on Saturday mornings at the Exton Senior Living Center over the course of this academic year has changed me.  Though I initially started off working with one patient, Mr. Kahn, I principally volunteered in the Bridge to Rediscovery ward of the Exton Senior Living Center.  The patients there, generally, were suffering from late stage Alzheimer’s and dementia, and what I saw changed my outlook on end of life care.  I was met with blank stares, disconsolate family members, and a relative malaise that hug heavily in the air.  Even though I could tell that my music playing helped slightly, I know that music can not and will not heal these debilitating diseases. 

The monotonous desperation etched onto these patient’s faces has caused me to reevaluate whether or not being on the front lines of medicine is what I fundamentally want.  I now know I want to put my efforts into public health and public policy.  There is a criminal lack of funding, and information, that exists for these most debilitating diseases.  Having seen how negatively these diseases affect, not only the patients, but also the families, not to mention the economic burden placed on them, I am determined to positively impact the policy surrounding medicine in an effort to keep the public healthier and more informed.

For me, the biggest unanswered question raised during my volunteer experience is: how do we not know more about this disease?  We scientifically know a little, but our efforts on understanding why these proteins fold and why their aggregation is nearly irreversible have been almost for naught.  This lack of information links back to my desire to see an increase in the funding for research into these debilitating and life-ending diseases.  Similarly, medicine is reaching a scary precipice.  Many scientific papers and review articles have been murmuring about the end of the antibiotic era.  Cancer is becoming increasingly difficult to cure, fear over new pandemics are palpable, and Alzheimer’s is essentially a death sentence.  More money needs to be injected into the sciences and health research.  If we, as a species, are to overcome these afflictions and challenges, we must devote more policy and funding to our biggest health risks.

I could not be more grateful for the opportunity to volunteer with Holisticare Hospice.  My experiences have given me a clearer understanding of what I want to dedicate my career to, and they have given me a deeper perspective on life and how valuable and sacred life is. 

Terrence L. (Swarthmore College)

Although the time I spent with my patients was limited and my experience with the Hospice was not as extensive as I hoped, working with terminally ill patients as well as my own experience of illness helped me realize the complexity of the experience of sickness and the importance of practicing medicine as art as well as science.


Growing up in a family of doctors, I could simply visit my grandfather’s clinic like it was my second home and rely on my father’s medical expertise. Upon visit to the doctor’s office, I knew exactly what my illness was, what body parts were affected, and what precautions to take for the next few days. I came back with a list of food to avoid and pouches of pills to take after very meal, and I even knew which pink pill made me drowsy during the day. Every illness was a pending question and doctors were essentially answer givers.

However, when I was sent to the Emergency Room at three in the morning, whether or not the cause of the illness was deathly, it was extremely frightening, especially by myself far away from family and friends. I was placed on an empty bed and did several tests, after which I was by myself waiting for what seemed like a few hours. When the chest x-ray revealed everything to be normal, I was immediately dismissed and I came out of the hospital feeling more puzzled than before.  Even after a few days, the symptoms insisted and I felt like I had no control over my own life, the prospect of which was terrifying.

Although it ended up not being anything too serious, what I needed more than an accurate diagnosis was a human touch - genuine concern and care for my wellbeing. I still cannot imagine how I would have felt had I been diagnosed with a terminal illness at that time. Yet, having gone through my own experience of illness, I was better able to grasp the importance of the mission of Hospice and to appreciate the impact it had on some of the patients I worked with. I could also appreciate at a whole new level the optimism some of the patients maintained despite their conditions.

Physicians today, as providers of health care, often forget that a knife only cuts and a drug only delivers and what makes a good doctor is not just knowledge but also compassion and concern for the patient’s welfare. Yet, my experience with Hospice helped me realize the importance of practicing medicine as art as well as science. Whether it be understanding the psychology of illness or grappling with the kinds of existential questions the patients deal with, I found that the human values related to the experience of illness are often more significant than simply an accurate diagnosis or treatment.

Until now, a disease, to me, had been as a series of biological events, whether it be genetic predisposition or a cellular event gone awry. But this experience taught me that every sickness tells a story and in treating a patient, it is important to look for not only the reasons why a person is sick but also the reason behind the reasons. After volunteering with Hospice, I want to become a doctor that treats the patient rather than the disease.

Deena B. (Haverford College)

Thinking back on my year with Holisticare Hospice, I think about what an amazing experience it has proved to be. I have experienced so much in so little time with my patients and yet I feel I have also gained so much. The work has affected more than I think I can currently understand; it has furthered my interest in medicine, but also in public health and the health care system.

My first patient, John ,made me realize the importance of family. He didn’t remember much, but every time I came to visit, I heard about all four of his children and his wife.

Since his passing, I have visited with Mary, Susan, and Leah (names have been changed). All three have incredibly different backgrounds and abilities. My communication, or lack thereof, with each of them has given me more insight into what it means to really slow down for an hour and just be with someone. One of my favorite parts of my visits is the drive to and from the facilities. Hannah, Frannie, Nancie, Gad, and I meet up and make the hour drive. I always look forward to the time I have with the girls to the facility, as it is a time for us to talk about our busy schedules, things we are anxious or nervous about with our patients, and whatever else is going on. After our visits, there is always so much to talk about on the way home. It is a great time to share anecdotes from our patients. After John passed, this time was particularly important for me. Since the girls had heard me talking about our visits so often, they felt just as connected to him as I did. 

Hospice has influenced my understanding of medicine in the realm of pain management. There is so much more to pain management then painkillers. Susan showed me this through her visits with dogs. In addition, techniques that Holisticare employs to help people relax and reduce anxiety go so much farther than ordinary medicine. I still have questions, but they go beyond medicine of the patients. I wonder about their families and their lives before they were moved to Freedom Village. I wonder what life was like for them when they were my age. I wonder if people visit them frequently, or if our role as visiting volunteers is bigger than we may realize.
My time with Holisticare has influenced my career s a doctor. I find myself thinking about the patients I have encountered; I wonder what it is like to be a doctor visiting them. I feel that I have seen a different side to medicine, which involves forming a bond with the patient. Today, it is so uncommon for a physician to form a bond with a patient since visits average such a short amount of time. In work with Holisticare I find that I want to work with these patients and get to know them.
Overall, my work with Holisticare has been such a special opportunity that I am so thankful to have. I know that my volunteering with this hospice program will continue far beyond this year. I want to thank Cyndi and Graham for all of their work with this program. I hope that it continues to be a program for people to apply for as it has changed me for the better.

Elaina H. (Bryn Mawr College)

My Hospice experience has taught me a lot about death and dying and about our current “culture of dying” in life in general and also in patient care.  From the reflection sessions we had I got the chance to stop and think about grief. Personally it made me realize that grief is a process, not only for those who lose their loved ones , but also for  those in Hospice as they are about to  pass on. I had never stopped to think what it would be like to be given a time frame of the number of months you have live, or to be alone during the last days of your life. As such when I volunteered I became more sensitive  to this and reflected on it more as a person.  It made me realize that death, as much as it is natural and we will all go through, remains as something we never do much to prepare for. In fact we barely ever talk about it. That why it becomes increasingly difficult to deal with patients about to die.

Additionally my hospice experience has helped me refocus and think deeply of my role in medicine and the reasons I want to go into healthcare. Instead of thinking of the honor and good repute that comes with the hard hours of medicine, it has made me realize and understand more that clients in medicine are sick people, in pain, not just scientific specimens with conditions and diseases awaiting eradication.  I now realize how easy it is to be swept into that line of operation and thinking and forget to heal patients and take away pain from them. Hospice drew me back to the humanity of medicine. At my site, I saw many people in pain; unable to sit or walk without groaning or asking for help and I realized that the more I take that into account the more I can become a better person and hopefully a better Doctor. Hospice reminded me what I thought I already knew: A career in medicine is about working with people and making them feel better. It sounds very simple but it takes a lot of compassion, patience, endurance on top of  the hard work and lots of studying. Be it from sitting for a long time with no conversation to feeling unappreciated and still doing it anyway. Despite this sounding very challenging it reaffirmed my decision to want to become a Physician and help ease people’s pain. The one question I hope to have answered as I continue to pursue my career choice is that, when does it get better, if it does? How does the care giver in a health setting not get too involved or attached?I remember being worried about Mr. D when I was away for spring break and silently wishing and hoping that his time would not come before I came back.  I felt that I was going to lose him and even though we do not talk that much, coming to see him had made him a part of my life. I guess it might qualify as a fear of mine as I walk into healthcare that, when I can do nothing or have done everything I can, how will I deal with the loss? Will there be avenues to channel my grief as a physician and care giver?

Francesca G. (Bryn Mawr College)

My work with hospice has given me a new perspective on death and has made me much more comfortable interacting with patients, especially those who are near the end of their lives.  Coming in, I thought of death as something to be avoided and I considered it a part of the job responsibilities of physicians to help their patients evade it for as long as modern medicine would allow.  After getting to know both the patients and the practitioners of hospice care, I have learned that the death to be avoided is one that is emotionally and/or physically painful, and therein lays the true responsibility of doctors and nurses. Death can be a beautiful experience, one that the patient and the patient’s family are prepared for and even embrace.

Personally, my favorite part of volunteering was the opportunity that it provided for me to take a break from my busy routine.  I appreciated that it forced me to set aside time in my schedule that was not rushed or on a deadline.  The first time that I went, for example, much of the time was spent chatting with Babette, but some of it was spent silently.  My gut reaction was to try to fill the silence, but eventually I realized that she was tired and that sitting quietly next to her was actually more beneficial to her than trying to make idle conversation.
Though the drive to Freedom Village was long, I was grateful for the time to talk with other volunteers about our experiences and process the visits with them.  We talked a lot on the rides home about what had happened during our hour with the patients, some times very funny stories and some times sad ones. It was good to have people to share this with directly after the visit.  The monthly meetings also provided a forum for support, which I valued.  I liked hearing stories from other volunteers and learning from their experiences, as well as sharing some of my own.
Volunteering with patients has influenced my career in a couple of ways.  Firstly, it has driven me to pursue working in community service before applying to graduate sFrancesca G. (Bryn Mawr College)
My work with hospice has given me a new perspective on death and has made me much more comfortable interacting with patients, especially those who are near the end of their lives.  Coming in, I thought of death as something to be avoided and I considered it a part of the job responsibilities of physicians to help their patients evade it for as long as modern medicine would allow.  After getting to know both the patients and the practitioners of hospice care, I have learned that the death to be avoided is one that is emotionally and/or physically painful, and therein lays the true responsibility of doctors and nurses. Death can be a beautiful experience, one that the patient and the patient’s family are prepared for and even embrace.
Personally, my favorite part of volunteering was the opportunity that it provided for me to take a break from my busy routine.  I appreciated that it forced me to set aside time in my schedule that was not rushed or on a deadline.  The first time that I went, for example, much of the time was spent chatting with Babette, but some of it was spent silently.  My gut reaction was to try to fill the silence, but eventually I realized that she was tired and that sitting quietly next to her was actually more beneficial to her than trying to make idle conversation.
Though the drive to Freedom Village was long, I was grateful for the time to talk with other volunteers about our experiences and process the visits with them.  We talked a lot on the rides home about what had happened during our hour with the patients, some times very funny stories and some times sad ones. It was good to have people to share this with directly after the visit.  The monthly meetings also provided a forum for support, which I valued.  I liked hearing stories from other volunteers and learning from their experiences, as well as sharing some of my own.
Volunteering with patients has influenced my career in a couple of ways.  Firstly, it has driven me to pursue working in community service before applying to graduate school.  I have found volunteering to be very fulfilling and recognize that it has given me as much or more than I have given the patients, and I would like to continue doing so.  As such, I have applied to AmeriCorps’ Health Corps program, and (if accepted) will be beginning my year of service in September. I would be working to expand access to high quality health care to underserved populations in the city in which I grew up. I could not imagine a better program for my gap year, and I have the hospice volunteer program to thank for inspiring me to seek it out.  Additionally, in my future career as a physician’s assistant I will approach death with compassion and understanding, not fear and avoidance, and I will aim to make my patients’ end of life comfortable whenever possible.

chool.  I have found volunteering to be very fulfilling and recognize that it has given me as much or more than I have given the patients, and I would like to continue doing so.  As such, I have applied to AmeriCorps’ Health Corps program, and (if accepted) will be beginning my year of service in September. I would be working to expand access to high quality health care to underserved populations in the city in which I grew up. I could not imagine a better program for my gap year, and I have the hospice volunteer program to thank for inspiring me to seek it out.  Additionally, in my future career as a physician’s assistant I will approach death with compassion and understanding, not fear and avoidance, and I will aim to make my patients’ end of life comfortable whenever possible.

Karter S. (Swarthmore College)

Hospice volunteer at Harlee Manor was a unique experience that changed my perspective of the medicine. Now, I believe that the field is crucial not only for maintaining patients’ lives but also for providing them with the comforts and mental stabilities.

 Through numerous volunteer experiences and externships at nearby hospitals, I was able to take a glance at the doctors’ lives. However, I have never had a direct interaction with the patients. When I first visited Harlee Manor, I was filled with expectations as well as anxiety over whether I can initiate a smooth conversation. Nevertheless, the short talk with one of my clients, Philomena, soon put smile on my face. She greeted me with a warm hug, and we soon began to talk about trivial subjects ranging from our plans for the day to the stories of her family. Despite her deteriorating physical condition, she remained emotionally stable throughout my visit.


  The driving force behind her smile was a hope. The helping hands from the physicians, nurses and her companions at the rehabilitation center motivated her to live positively. Furthermore, my visit seemed to have enlightened her mood. I was amazed to learn that my mere presence can impact somebody’s feelings. The patients’ physical conditions are not always proportional to their emotional stabilities. Rather, they can remain hopeful and optimistic even in the midst of physical distress.
  I also learned to help patients escape from the past. When I talked to the clients with severe dementia, they avoided my eye-contact and kept whispering about any past regrets they held of people or the events. They sometimes cried not being able to overcome the tide of past feelings. Thus, I had to frequently use the word ‘future’. I genuinely wanted them to look toward the future. After several attempts, I was able to comfort them. Although my words would not have changed the clients’ attitudes, I hope I guided them to turn their eyes toward the future.
  Through these diverse types of experiences, I realized that the field of medicine should take a more active role in alleviating the patients’ physical pain as well as healing their minds. The image I had of the physicians was a care-taker who provides appropriate medical treatments. However I realized that their roles extend beyond these tasks. Instead, they can potentially alter the attitudes of patients and their families. In that sense, the hospice is a well-suited treatment. Harlee Manor provided patients with a wide range of activities from watching movies to solving the random quiz. In other words, they are given an opportunity to resume the normal daily lives. Their illness should not become a primary focus. Rather readjusting their views of themselves and the world should be emphasized.
           I hope that the number of these rehabilitation centers increases in the United States. Furthermore, the health care cost of using the services should decrease so that more number of patients can get an access to the optimal care at the rehabilitation center.

Bailey K. (Bryn Mawr College)

Being a volunteer at Holisticare Hospice has been a very valuable experience. I had the pleasure of meeting some wonderful patients as well as volunteers.  One of the main things I will take with me from this experience is importance of just being with someone. You don’t have to talk or do anything, just be with that person. This lesson has translated to my own life in how I choose to spend time with my loved ones.

Hospice has influenced my understanding of medicine. It has made me realize that medicine is not always the answer when it comes to certain patients. As an aspiring physician, I always believed that one should try their best at healing a patient and that involved using medicine. However, sometimes, the best thing for patients could be not using medicine at all, or just using medicine to take care of pain and not necessarily illness. Medicine can sometimes cause more pain and turn out not to be beneficial for the patient at all.

A question that I had before completing this program was wanting to know what exactly goes on in a hospice. I knew it was a place to go for end of life care, but I really wanted to know how that played out. This question of mine of was answer after doing training and seeing patients. I learned that hospice is a team of strong individuals who want to give a patient all the comfort they possibly can before their passing. There are many different jobs such as doctors, nurses, and volunteers, who not only focus on the patient medically wise, but also spiritually wise, which I believe is a beautiful thing. A question that has stilled been raised in my mind is why don’t physicians introduce this option to their patients early on?

This program has influenced my future career as a physician. It has been the confirmation that I do truly want to become a physician. It has also influenced me to make sure I am fully listening to my patient in terms of how they want to go about their treatment. People know their bodies better than anyone else, so if a patient says that cannot take or do not want treatment anymore I will take that very seriously. I also will make sure to introduce hospice to my patients as an alternative treatment option that focuses on them feeling better but not necessarily curing the illness. Another thing that I’ve taken away from this experience is to make sure I look at the patient holistically. I want to treat them but also provide them with the information to stay healthy on their own. Hospice has made me realize that people benefit more from a holistic point of view. Hospice provides physical, mental, emotional, and spiritual help, which I want to incorporate into my career as a doctor.

Helen R. (Swarthmore College)

Volunteering with the Care Alternatives hospice has helped me to learn many things about myself, the ageing process, and the importance of caring for others.  Every week, I visit three women in the hospice.  They are all very different and have differing abilities to communicate but I always enjoy spending time talking and interacting with them.  It is easy to see that these patients are eager for company and are excited when they have visitors.  While they don’t always remember that I’ve been there before, they are happy when they hear that I am there to see them.  Being able to spend my time with these women is very rewarding. 

I have been fortunate thus far in my time volunteering because all of the women I see have been relatively stable and healthy.  During my training process, I was preparing myself for dealing with a lot of sad things during my time with the hospice.  I do find it challenging to be in the hospice facility and to hear the patients I visit talk about how they cannot remember their families.  I am still unsure how the hospice experience will affect me when I must deal with the deterioration of my patients, but I feel better prepared and I think it will be a valuable learning experience when it happens. 

My time volunteering with the hospice has certainly affected me in positive ways.  Getting to experience the ageing process first hand has made it feel a lot more natural and less scary than I had imagined.  I personally have become more comfortable talking to people I don’t know and people in difficult situations.  I think this skill will be immensely important in any career.  If I choose to pursue a career in medicine, the knowledge I have gained in working with hospice patients will undoubtedly help me to interact successfully with my patients.  People are so grateful to have someone listen to them respectfully and as a doctor, that is one of the most important factors for building a relationship with patients.

In general, I think that doctors would all benefit from working with hospice patients.  It is important to establish a good bedside manner and to be able to interact with patients on a human level.  In a clinical setting, a doctor must meet with patients as quickly as possible and make an effective diagnosis with little time for any connection.  Taking the time to sit down with hospice patients and help them by listening with compassion could easily translate into a greater sense of compassion and respect for medical patients, something that is often lacking in the medical field.

One of the most personally rewarding parts of spending time with hospice patients is that I remember to be grateful for the many blessings in my own life.  It is easy to get caught up in the stress of college, but after visiting the hospice, I always appreciate things that are easy to take for granted, such as my memory, mobility, and social interactions.  Experiencing this mindfulness has been a source of comfort and relaxation for me during this semester.  It is always fulfilling to spend time volunteering.

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