I applied to the hospice program in the hopes that I would gain a better understanding into the world of death and dying. Interestingly enough, I have actually learned another valuable lesson. I have learned how to ignore the stereotypes surrounding those who may look ill from the outside, and instead focus on their soul within that is wise, worn out, and most of all beautiful.
I was lucky enough to be paired with an elderly lady from India who was coherent, expressive, and interested in my life. We got along very well and I would look forward to the times I would spend with her. As the visits progressed, I would find myself using the last few minutes of my drive as a small pep talk and would turn down the music so I could shift my mindset. I would remind myself that I was coming here to see her and nothing else going on in my life should distract me or steal my attention while with her. Realizing that she does not receive as many frequent visitors nor does she have close friends in the facility, I placed a greater emphasis on my visits to her. I made sure that I was either bringing something for her or had an activity I could do with her to make our times together more memorable. For example, I brought home cooked Indian food for her, I brought baskets and a scented plant to organize her room, I painted her nails, gave her a hand massage, and left a scarf of mine that she liked. In addition, I would have my parents who spoke Hindi facetime us when they were with my 2 year old nephew so she could speak her native language and smile at whatever my nephew was doing, I brought her Indian snacks when I visited India, and many others.
Besides all of these, I would look forward to talking to her and learned to listen as she slowly told a story. I realized that it was much more difficult for her to speak about the death of her husband who died many years ago than to talk about her own death. To me, it seemed as though her happiness, will to live, and purpose in life declined once her husband died. Oftentimes, she would say that there is nothing for her and she is basically living like a “dead body” with no one to take care of her. This was heartbreaking to hear, especially since I was looking at a woman who was much more capable than others placed in Hospice care. But I learned that dying does not necessarily mean that a patient is physically declining, but rather the hardships of loneliness and depression can impact one’s mental state enough to feel as though they are dying. Of course I empathized with her, because who wouldn’t be frustrated living a life confined to a wheel chair and not able to perform any basic daily functions? Additionally, Indian families pride themselves on having three to four generations living in the same house, respecting their elders, and caring for sick family members. While the care she receives at her facility is great, I can tell just how sad and resentful she is that her own children would not take care of her in their house. Above all, she told me that her children are always in a rush to leave the second they come to visit her. We live a society where there are constantly tasks to check off our list and we have a time crunch to do them all. But when I would visit my patient I learned that time, company, and attentivness are three things that can go a long way. Sometimes I wouldn’t accomplish anything or talk about anything meaningful, but by being present, not checking my phone, or seeming disinterested I’m sure my hospice patient enjoyed having someone else in the room she could talk to and ask questions.
I have learned many things from my hospice experience but I have also had moments where I left the facility wondering if I had made things better or worse. A few times, I would ask a question about her family and she would start crying, grab my hand, and tell me horrible things that she thinks at night. One day I asked her, “What makes you happy?” and she looked at me and said, “Nothing, nothing can make me happy anymore.” As someone who is a problem solver, this was heartbreaking to hear. I realized that at this point in her life, there is no amount of food, clothes, or jewelry I could bring her that would erase the difficulties she faces every day. Whenever a friend is sad or upset, I try to offer advice and give them a solution of what they could do to help their situation. But in her case, I realized I wasn’t here to “fix” her. She had been broken and all I could do was sit with her through the pain and try to focus her thoughts on the present.
These are definitely aspects that I feel may help me save lives and communicate with patients in the future. I have learned to develop a more understanding manor and pry just enough information before I hit a sensitive topic. I will utilize these skills when speaking with patients and learning about their family history or about how they have ended up in their current state. I will be one of the few doctors who have a much better understanding of death and dying, and keep in mind that many of these elderly sick patients really don’t have a strong desire to live. Knowing this information, my course of treatment may vary and I will be able to communicate this to the patient’s family, which is a large part of a doctor’s work.
The hospice program has definitely been a humbling experience. While I have formed a beautiful relationship with a funny and kind lady, I have also become much more compassionate to other people and their daily struggles. Everyone is dealing with his or her own demons and it is my job to listen without judgment and offer advice only when needed. I have truly enjoyed the hospice experience and am extremely grateful that I was paired with a lady I could so easily connect with. It has shaped my outlook on death and dying as well as personally affected how I plan to deal with other people’s issues now and in the future.