Hospice was an area of healthcare that I was familiar with only to the extent of it being a period of a patient’s life where defeat is accepted in the face of death. Whether it be by physicians or a patient’s family member, this end-of-life care was projected to be a moment of sadness and hurt. It was as if there was a taboo around this word, and nobody wanted to be near it as it was correlated to falling into the arms of death. However, little was I aware that my simple fascination in understanding the workings of this niche area of terminal care would slowly become some of my most cherished hours spent living.
Weekend mornings regardless of rain or snow, stepping in through the automatic doors of my facility decorated by a welcome sign and seasonal stickers always felt like sunshine. The soft smiles on the faces of nurses and patients scattered throughout the entrance lobby put a matching smile on my own face, eager to see my patient. However, there were many days when walking into a visit with a smile on my face was not enough. My excitement to pick up where I left off with my patient was not enough. In moments such as those, it was easy for me to spiral into a self-reflection of what had I done wrong? Why is my patient not communicating with me? Are they upset with me? Looking back at these question that once consumed my mind when a visit did not go according to my expectations, I realize the root of the problem. The visit is not about me. It is not even about how the patient feels towards me. Rather it is about what I can contribute to the patient at moments when they are feeling at a hundred percent or twenty percent. On low days or high days, each time I stepped into their room for my hourly visit, my responsibility solely became to fill their energy tanks when the patient themselves could not.
Patient 1 was often bedridden due to weakness she felt and lacked an ability in hearing which would lead to 60 minutes of very competitive rounds of Pictionary on my iPad between us. Patient 2 lived with his wife and had trouble with memory and hearing, the stress and anxiety often clearly visible on his wife’s face in moments when the husband could not recognize her. Comfort and moral support are what she needed and that is what I aimed to give when with patient 2. Through small actions of letting her know that the nurses are aware of her husband’s needs/requests stopped the bucket full of her racing thoughts from spilling over. Patient 3 suffers from memory loss and has reoccurring mood swings rooting often from a poor sleep and communication barrier. Partaking in activates that required minimal talking such as slow-paced walks and mindlessly marking of colored pencils onto paper gave the patient a sense of control she desired. Regardless of the patients’ illnesses or their state of behavior upon my arrival, I believed there was always something that could be done to temporarily lessen their pain by catering my time uniquely to their needs and hobbies.
The time spent with my patients in a hospice environment harbored an ability to not only cherish the smiles on good days but to push to find the positive in moments of pain, distress, and anger. Besides treating the physical disease of the patient, as a physician it is crucial to see what the patient is at the end of the day: a human. A human who faces adversity like a mountain which has high blissful peaks and low, dark valley. In the face of an illness, terminal or not, patients fall into these low depths where sunlight is scarce, but it is not lost. It is this message that I hope to carry as a reminder of hope when confronted with patients struggling to hold on by themselves. While I may not be able to cure all the patients back to their full potential, I can continue to contribute to their growth by validating their presence through comfort, hope, and encouragement.