Dealing with the mundane stress of the COVID-19 pandemic has been quite exhausting: academically, emotionally, spiritually. In these times of prolonged isolation, I am constantly reminded of the importance of human connection, something we have all been greatly deprived of over the past year. While I did not get the chance to build patient relationships this time around due to travel restrictions, through the hospice program activities I was still able to gain insight on death and the nuances that surround it and how we talk about it. From learning about different cultural perspectives on death, to reflecting on the implicit biases that plague all human interaction, I have learned that being a doctor is not only about caring for a patient but caring with them—a patient-centred approach.
My broadest takeaway is my deeper appreciation for palliative care and its emphasis on helping patients to come to terms with their greater psychological and spiritual needs. By centering the psychosocial and spiritual needs, we see patients as humans, not statistics. This psychosocial-spiritual model reminds doctors and caretakers to prioritize a patient and their family’s desires rather than imposing their own etics. Nevertheless, it is important to discuss the possibility of dying early on. If the idea of death is only brought up when crisis strikes, it is often too late. Being ill-prepared to face death can be emotionally traumatizing for both the patient and family members. Attending to a patient’s holistic needs ultimately eases the acceptance of death.
In addition, living longer is not always the goal. Doctors can be too optimistic and continually try treatments at the detriment of a patient’s quickly declining health. Paradoxically, sometimes the best course of action is no action. If treatments will ultimately cause more suffering, with the agreement of the patient and family, it is a good option to reduce treatment to only symptom management. That way, patients can try to optimize their last months, weeks or days without the stress of false optimism. Allowing family members to spend more time with their loved one can also reduce the risk of feeling ambiguous loss.
Throughout this hospice program, I have also tried to place more importance on my own mental health. It often still feels selfish to practice self-care, and I am left feeling guilty if I give myself time to rest. It is very much a work in progress, but learning to find sources of my own mental wellness is mandatory work. Especially if I continue to pursue medicine. Dealing with death on a regular basis will only add to the stress of day-to-day life. Maintaining good mental health is not only important for doctors on a personal level. The significance extends to interpersonal interactions with patients by providing a buffer to compassion fatigue.
While it is unfortunate that I did not get to apply much of what I learned, I am sure that my new found knowledge will guide me not only as a future physician but also in how I interact with friends and family.