I was lucky to have had the same patient, Sally, for the entirety of my participation in the hospice program. Creating a meaningful relationship with Sally was easy; she is talkative and loves having company. We spent most of our time together talking about her family. She has 5 children and a number of grandchildren, each of whom she is exceedingly proud. In addition, she would reflect on her past, often telling stories about her relationship with her husband and the hobbies that she enjoyed when she was able to. Through these interactions with her, I found myself more appreciative of my life as it is.
This relationship with Sally was my first real experience with end-of-life care and also the first relationship I developed with a patient. As a result, this experience has increased my exposure to medicine outside of a formal setting and has strengthened my medical school application. I have shadowed and volunteered in bigger hospitals a number of times, but I’ve never have experienced this less-glamorous side of medicine. One of the major takeaways I’ve gained from this program is a more comfortable relationship with death. During my first visits, I often felt uneasy when Sally would ask if I was with hospice. However, through discussions with her I could tell that she had come to terms with the fact that she was at the end of her life, and this made me more comfortable with the idea of death. Several prompts discussed the need for families to talk about death, and to make decisions related to end-of-life care earlier in life to assure that families are ready when an incident may happen. Further, they discussed a need for physicians to become more comfortable with the idea of death so that they can provide their patients with the best care possible. I feel that I have gained more comfort with the concept of death and that this makes me a better applicant.
With all that being said, I constantly left my visits feeling unsatisfied with Sally’s situation. She was mostly alone, sitting in a dark room unable to care for herself in any way. She had family around, but having been on hospice for nearly two years, it was clear that visits were becoming less frequent. Although the facilities offered activities for patients to partake in, these were usually for about an hour a day, and Sally often did not feel up for going. She was unable to eat anything that was not in fluid form, and she required the help of multiple nurses to get dressed, bathe, or go to the bathroom. As a result of this lifestyle, Sally often discussed how deeply sad she was to be in this state in hospice care.
I found, and continue to find, myself constantly wanting to change this. What more is there that we can be doing for patients like Sally? During this program, several prompts discussed understanding when the right time to let go is. While there are often treatments that can be done to save a person, they are sometimes drastic measures that lead to a substantially decreased quality of life. On the other hand, allowing a patient to pass would have given them a more peaceful end to their life. I grew to better understand these concepts through my interactions with Sally, and these lessons have increased my desire to pursue a medical career.