Throughout the last year, I have volunteered with three different women suffering from Alzheimer’s, and in doing so, I have reflected on life and death. I think a lot about my own grandmother, who has Alzheimer’s, and how she has been incredibly fortunate to receive very high-quality, in-home care. In contrast, my most recent patient, Jackie, often expresses loneliness, depression, and lack of freedom in the nursing home. Although I read about these feelings (and more) in Atul Gawande’s Being Mortal, they had a greater impact on me when I saw them firsthand. I have realized how much I take for granted the little things in my life, such as being able to move, eat, and socialize as I please. I also realized how much impact I can have on a patient by giving them only a few hours of my time in a week.
My experience has also helped me become more conscious of what is beneficial to older patients. Having taken a health economics course and public finance course this year, I learned about the utilization of cost-benefit analyses to determine whether care is “worth it.” It may be easy to place a value of the costs and benefits of a medical procedure or treatment. But through this experience, I have learned that hospice care has the ability to simultaneously reduce the medical costs of advanced treatment and maximize the benefits through improved quality of life until the very end. This message is echoed in Sunita Puri’s and Dhruv Khullar’s articles in The New York Times. During my visits with Jackie, I assisted with small but fun activities, such as reading a novel of short stories or coloring with her, which appear to have an immensely positive impact on her. I will remember and build on these experience through my medical school application, training, and beyond.
In my conversations with Jackie, I have also learned a great deal about what it means to leave behind a positive legacy. As a wood sculptor, Jackie has left behind many beautiful artworks. However, she also has had a lasting impact on others, including those who came through her studio, and her children who were blessed with similar artistic abilities. Jackie often references her own mother, her twin brother, and her children, and it is clear that they bring her the most joy. In a world of materialistic people, it is refreshing to be around Jackie, who sees importance in the people who make up our world. She is a constant reminder to me to focus on how I can better the world, even in the smallest ways.
While it saddens me that she may not be around much longer, it is uplifting to remember that her life was filled with positive impacts on others. I recall that when death nears, we should celebrate life. I thank Jackie for her impact on this world, and on me. My experiences with her will never be forgotten, especially when I will be forced to make difficult decisions regarding end-of-life care. I am hopeful that I may be able to continue volunteering during my senior year, because I am confident that there is still more to learn.