During my first visit to the facility where I was assigned, the plan was to start at a random patient and cycle through the rest at equal time intervals. This plan went out the window as I ended up staying with my first patient that visit and all of the visits afterwards. When I entered May’s room, she groaned. I had apparently interrupted an afternoon nap. However, the nurse on duty entered right behind me and brightened the atmosphere. She chatted with May about her recent visit from her nephew, while fixing her pillows and making sure she was comfortable. The nurse had to make most of these adjustments for May, as she was barely able to move from her position on her side. Though she was slow to respond, her mind was present. As the nurse left, she said, “Be careful with May… She’s a firecracker,” and May pooh-poohed her with a wave of the hand and a quiet chuckle.
In this jovial atmosphere, I started our visit. We began discussing her life, but when she quickly got tired of talking, she asked about my life instead. Though May worked at a department store, I believe that she would have been a great detective or journalist. By just listening and asking the occasional question, she learned about my family and friends, where I’ve traveled, what I want to do after I graduate. The visit proceeded like this, with me chattering away and her interjecting related stories, clarifying questions, and providing bits of wisdom and advice. All of a sudden, an hour had gone by and I had to go. She told me to come back the next week, and I did.
My mom has been a therapist in a nursing home for 25+ years. Sometimes, she would bring me to work to meet one of her patients. I always wondered why they would want to meet me, a child. May’s smile when I talked to her was the same smile that I saw when I was a child meeting my mom’s patients. In that smile, there was a joy in knowing that there is something or someone other than oneself, that there is life. May and I never talked about death. But as she came to terms with her impending passing, I believe that made her that much more able to appreciate and talk about life.
Through hospice training, I read The Death of Ivan Ilyich by Leo Tolstoy and Being Mortal by Atul Gawande. Beforehand, I thought that the point of medicine is to treat and cure patients. In this traditional line of thinking, the wants and needs of the patient themself is cut out of medical care decisions. In Being Mortal especially, I came to understand that a partnership between the doctor and patient is critical. Though the elderly are adults, they are a population that, in large part, is disenfranchised. Through the readings, I learned of the doctor’s role as an advocate for the wishes of the patient. The hospice experience has made me more mature and taught me how to interact with patients. Just as important, hospice training has taught me to listen to and respect patients’ wants and needs in my future career in medicine. Though May was dying, she was able to appreciate life in her last days. I understand now that she was only able to do so from having her wants and needs heard. After this experience, I look forward to pursuing a career as a physician, as an advocate for my patients.