The journey to medicine is often misleading. Medical schools recruit based on grades, research experience, and MCAT scores. This emphasis on scores and science more often than not makes pre-med students overlook other crucial aspects of medicine such as taking care of dying patients. As a premed student, I want to become a doctor and heal people, but I often forget that sometimes people–young or old– die, regardless of how competent doctors are. The Athena Institute Pre-med Hospice Program reminded me that death is real and part of the medical sphere. From this program, I learned that a good doctor should not only be good at treating patients, but he/she should also be good at caring for dying patients.
So how can I take care of dying patients (once I become a doctor)?
Reimagine death: In the video “Being Mortal,” Dr. Atul Gawande mentions that there are two unfixables in life: “Aging and dying.” In medicine, death is often surrounded by negative emotions such as failure. To cope with this sense of failure, doctors lie to or run away from dying patients. This pre-med program challenged me to reimagine death and stop seeing death as a failure or defeat, but an inevitable part of the medical career. The main challenge then becomes: How can we help the dying patient pass in peace? This is a question that all pre-med students should consider before joining med school. Reimagining death means that we should see beauty in death and stop avoiding the inevitable.
Know patient’s priorities: Priorities include all the things that a patient values or wants to do before death. Priorities also include contingency plans in case of emergency and other events that should take place after death. Dr. Atul Gawande argues that doctors need to recognize that, above all, patients are human beings with dreams, wishes, and goals even though their life might be coming to an end. Therefore, doctors should talk to patients about what matters the most in their lives. When dying patients have their priorities met, it brings great comfort and a sense of peace/relief. Knowing priorities also helps doctors better care for the dying.
Eradicating unnecessary suffering: In his Ted talk, BJ Miller asserts that they are two types of suffering, necessary and unnecessary, and good doctors ought to know the distinction. Necessary suffering is part of life and cannot be changed; on the other hand, unnecessary suffering serves no good purpose and can be changed. In the case of dying patients, necessary suffering can be viewed in terms of loss that comes with death. The dying patient suffers because he/she is leaving behind loved ones. The unnecessary suffering is the physical discomfort and symptoms associated with the pathophysiological issue of the dying patient. Physical discomfort can easily be alleviated if the patient is given palliative care, but in some cases, alleviating discomfort requires abandoning treatment that is invasive or does not help ameliorate the patient’s condition. When treating a dying patient, doctors should know when to forego treatment that is not improving a patient’s condition. Making such decisions early on reduces unnecessary suffering. For many people, it is the pain associated with death that makes them scared of death. Without pain, dying patients can find some beauty in death.
The Athena Institute Pre-med Hospice Program has helped me understand how I can compassionately care for the dying, and how I can cope up with losing a patient. These lessons are very important as I prepare to join medical school, and once I become a doctor, I plan to put them into practice.