I knew Alice had no idea who I was each time I walked through her door, so I made sure to introduce myself at the start of every visit. On some days, including the first time we met, she was very cheerful and wanted to take me around her floor. Other times, she was quiet. She was not always in the mood to chit-chat or to sit up in her chair. Nonetheless, Alice was always polite and want to entertain me, but didn’t always have energy to engage. I didn’t push her, and usually we just sat on her bed filling in adult coloring books and listening to her favorite music, big band.
In the beginning, I stressed about not knowing what to talk about. Somewhat fortunately, I could ask her the same questions between weeks because she forgot that I had visited her. But over time, the silences became less glaring, and together we just enjoyed the music playing in the background. I think she just enjoyed having someone pay attention to her since her children visited rarely. This is how our visits went, not trying to make anything specific happen, but just enjoying each other’s company. At the end of one visit, she seemed sad to see me go, when usually she barely seemed to notice. Since I mentioned I had been visiting her for weeks, she was afraid of forgetting that visit. I assured her that we would have more just like that one, and she seemed to like that.
This hospice experience has certainly been a new and challenging time. But I would not have given up this opportunity. Aside from direct patient interaction, participating in the program has given me insight into one of the major flaws within American healthcare. I do not plan on going into palliative medicine, but this program was still valuable because it showed me that doctors still have much to learn in terms of talking about and handling death. Dr. Khullar describes how 70% of doctors have not received training in this area, when death is an unavoidable topic in medicine. Many doctors are desperately concerned with how to prolong a patient’s life, but not enough conversations occur about how to provide patients a passing that they want and deserve to have.
Of course, going into this program I felt uncomfortable talking or even thinking about death. But dealing with the prospect of it so openly and frequently through the course of this program has allowed me to understand these larger conversations about speaking early and openly about death. As a future physician, I would like to learn more about how to have these difficult conversations with patients, but also have the personal experience needed to advocate for better end-of-life care. It is evident that most Americans are not dying well. Now, having a better understanding of this phenomenon, I feel more motivated to pursue this career and dedicate myself to improving the quality of one’s life and remembering to address the topic of death.