After only a few visits to “Millie”, it became clear that we had much in common. We both appreciated summers on the Jersey Shore, we both adored looking at photographs of dogs, and we both wanted to spend as much time outside as possible. On a deeper level, we both shared the tendency to choose the path of least resistance, even at a personal cost.
In “Millie”’s case, this manifested as a brilliant and notorious smile. As we strolled the halls together, other patients and caretakers alike frequently commented on “Millie”’s bright expression. However, as I got to know “Millie” better, I began to sense that the warmth of her smile offered a false sense of complacency: “Millie”’s personal struggles appeared hidden from the staff, her worries and concerns effectively trapped behind a grin with few words to express them.
However, as I sat and talked with “Millie”, these concerns would eventually find their way to the surface: while “Millie” might have sat dreamily in her room for a few hours, she in fact would rather have been downstairs watching the other residents play cards; while she appeared to absentmindedly fiddle with the ribbon on her lampshade, it was because she couldn’t get the lamp to turn on and off.
One memorable afternoon, I came to visit “Millie” in her room when I noticed a stack of unopened mail on her nightstand. When I asked who it was from, I was greeted with the infamous smile before “Millie”’s expression grew clouded as she admitted that she wasn’t sure when she had received the letters or whether she had opened them. I sat by her side and began to go through each one, where we were greeted by the faces of her grandchildren and great-grandchildren, accompanied by holiday greetings and updates from her loved ones. “Millie” was genuinely overjoyed and thanked me for bringing the letters to her notice.
After that interaction, I was left with a feeling not uncommon after my visits to “Millie”: that a sense of listlessness, helplessness or despair had been replaced by overwhelming hope. A common concern of healthcare providers is the anxiety brought about by feeling that a patient’s condition is out of your control. While I may not have been able to ease “Millie”’s dementia or her worsening vision, I still came away from each interaction feeling as though my actions had made a difference in her experience. In simply spending time interacting with “Millie” and carefully unpacking her life experiences and true desires, I felt as though I had broken through the barrier of complacency and allowed a true relationship to form.
As a provider, I will take away incredible lessons about aspects vital to every patient interaction, but especially those at the end of life. I have gained a newfound understanding of the importance of trusting my instincts and going below the surface to truly understand my patient’s needs, even when they appear satisfied. I will also remain reminded that I may not be able to fix every issue a patient encounters, but to approach the issues I can manage with compassion and enthusiasm.