I first applied to the Ascend Hospice volunteer program to expand my understanding of death. I felt that I had a solid stance on death from my religious and philosophical views. Nonetheless, I had very little experience dealing with death firsthand, and I had no experience with the dying process. Deeming such experiences necessary to be the empathetic doctor that I wish to become, I applied for Hospice volunteer program.
I had meaningful experiences with the two patients that I saw during the program. I was first assigned to Ms. A., who I unfortunately only got to see for two visits. My partner and I were introduced to her in a hospice facility and we last said goodbye to her in her home. We had been able to hold a conversation with her when we were first introduced to one another; this contrasted drastically with our last meeting in which she appeared to be asleep for the duration of our stay. It was surprising to see the rate at which her health deteriorated. Her family said she enjoyed bible stories, so my partner and I read some to her. I interpreted the small groans she gave as evidence that she could hear our presence. As a Catholic, I found the religious reading comforting, and I hope our patient did as well before she passed.
After Ms. A passed away, my partner and I were assigned to Ms. L., who taught me the importance of recognizing subtle forms of communication. Aside from smiling when we first arrived and as we said our goodbyes, she rarely seemed cognizant of our presence. When we tried to communicate with her, she usually did not respond. On the rare occasions that she did, her replies were indiscernible. It was by paying attention to details that my partner and I were able to enhance our interactions with her. We noticed her staring at a particular image in the memory book, a picture of a woman and a piano. From that, we had the idea of playing her some instrumental music and we started playing some piano music from YouTube. She very much seemed to enjoy the music, she would smile for the majority of the time that we played it.
From the beginning of the volunteer program, Ascend Hospice wanted us to know that death is inevitable by having us watch “Being Mortal” by Atul Gawande. “Being Mortal” was the first instance that I truly confronted the notion that fighting death at all costs might be fighting a pyrrhic victory. Yes, we as health professionals might wish to prolong the life of our patients, but at what cost if the patients are left for dead due to the gravity of the illness and treatment? My experiences as a hospice volunteer has taught me to respect and empathize with the rationality and views of death of my patients, especially when they are different than my own. Despite being presented with different views on death throughout this program, I still stand by my original views on death. However, I now approach different views with a newfound empathy and make an effort to understand others’ perspectives. I personally find the whole idea of “understanding death as inevitable is necessary to appreciate the meaning and beauty of life” to be kind of morbid, but I understand where Dr. Sunita Puri was coming from in his essay “The Lesson of Impermanence.”
Most of all, I have a newfound appreciation for all the nurses and caregivers who dedicate their careers to providing physical and emotional care to patients during these challenging times. My heart goes out to everyone involved in the caring process.