My first patient, Jane, was an animated talker and a lovable person. Visiting her was a surprisingly normal experience—every day I would come in and have a regular conversation with a regular person. A few visits in, I was walking through Jane’s doorway as usual, ready to say hi, but was stopped dead by her drastically altered appearance. Since our last visit, the color had blanched from her skin, and she lay in bed, exhausted. In an uncharacteristically thin, quiet voice, she requested that I come another time.
From then on, her condition was different every day. Sometimes we had great, lively conversations like before, and other times she was too tired to talk. I began dreading the weekly lottery, the potential weakened condition I might find my talking partner in. At the time, I was preoccupied with the decline I was noticing, and found myself obsessively monitoring her condition – pallor, bandaging, everything. However, as our visits progressed, I began to see things differently. My visits on the good days weren’t lucky misses; they were valuable opportunities to connect to Jane and provide friendly, normal conversation. It didn’t matter how her health was ranking compared to other days; that was beyond my control. The effervescent nature of the good moments was what made our meetings special, and those moments made every tougher one worth it.
As Dr. Gawande explained in Being Mortal, aging and dying are unfixable; they are realities of everyone’s life and, despite medical efforts, will be confronted one way or another. However, this reality contradicts the natural conclusion of intense, long medical training—namely, that the skilled physician must do everything in their power to ‘fix’ the patient’s ‘problem’. Tensions between medical training and the realities of losing patients cannot be resolved or taught in a school. For every physician, this struggle continues throughout their professional life, as it did for Doctors Gawande and Puri. As a volunteer with Compassus, I have had the opportunity to begin this journey early.
This program has helped me to understand that the challenges of practicing medicine are not just technical; they can be emotional and spiritual as well. When a patient is dying, it is inevitable that their physician will encounter struggles also shared by the patient’s loved ones. To feel this struggle is not to admit defeat; it is a humanizing experience and without it, medical work would be devoid of meaning. However, debilitating sorrow and frustration can be harrowing for medical professionals, which is why further steps are necessary. In order to ensure the humanity in medicine is retained alongside the health of the physician, understanding how to accept and normalize death is crucial. This program taught me that tending to the emotional side of palliative and medical care is just as crucial as any technical medical training.
Volunteering with Compassus this year has helped me uncover the unseen depths of medical work. Importantly, my patients have shown me that being a medical professional is not just about monitoring and fixing a human as one would a machine. Palliative work, as well as all medical work, is important because it can create opportunities for growth on both sides as an emotionally fulfilling and enriching experience.