Hospice Day 1, 2, 3, 4 (IM Days 21-24)

Last week was spent with patients who are on Hospice, and I had the opportunity to meet some very nice people and to experience a side of medicine we all pretend doesn't exist - the dying side.

First off, I'd like to comment on how poorly the media portrays death, and how horribly that has affected us as a society. In earlier times, when a family member was nearing end of life, the care was given in his/her home. Family and friends would stop by to help care for the family of the dying, and it brought a huge feeling of community and togetherness, peace and comfort. After passing, he/she was transferred to the parlor in the house, where family and friends could say farewell and wake services were held. The deceased would then be taken into church for the final blessings and funeral service before being interred near his previously deceased family. In modern times, this thought might terrify you - to have a deceased family member in your own home, to hold the wake in your front room, to have family and friends visit our beloved deceased in our own home! It has terrified us so much as a society that, in the 1890s, we renamed our parlor, and we now call it our "living room", and the practice of handling the deceased has changed dramatically. Additionally, in previous times the mourning were allowed to grieve for a year's duration, during which time any crazy action or hysteria was allowed and forgiven, as mourning was a time of understanding and open grief was permitted. A woman wore black, and all would know she is in mourning, and the rules of etiquette would not apply to her during that time of mourning, for an entire year. Now, a person is lucky to get the day of the funeral off of work, and if any additional time is needed to mourn, if it is allowed, at the very least the boss and co-workers aren't happy. We have dehumanized death to such extremes that we genuinely think that dying will not happen to us. But it is in our very nature, we are born onto this earth just as certain as we are to die. Why must we make that fact so difficult to accept, why must we constantly deny and ignore this ultimate truth?

This is where Hospice shines. Less than 10% of people die suddenly, without warning or preparation. The rest of us, over 90% of us, will die of an illness and there will be time to prepare ourselves and our families and friends. In our society, however, we deny the inevitable up until our last day, but that is not the case at Hospice. Beautiful memories are made, beautiful moments happen every day...there is a lot of closure and life-reflection during the last months/weeks/days of life, and if the patient understands that and is prepared to accept the inevitable death (and if the family does as well), the dying process can be a time of beautiful growth, a time when we can come to terms with our life and say our final heart-felt goodbyes. Hospice is wonderful at leading the patient and the family to acceptance, after allowing the other stages of grief to elapse.

That's not to say that death isn't difficult...the patients which I interacted with were younger than my parents, which makes it quite hard to accept. But the peace that was with the families, the peace that was with the patients, made it somewhat more acceptable. Of course I feel like the medical system failed them - surely we could have done more to have kept the patient alive longer, to have cured their illness, to have caught the disease in time before it consumed our patient?...And so I think that the act of dying is inappropriately taught as an act of failure during our years of education and training...we are trained to believe that the best thing we can do is save a life, to keep our patients from dying, and we certainly aren't prepared for accepting the fact that each and every one of our patients will die, and that it actually isn't a failure - it's an inevitability. I believe that the way to acceptance of death as a part of life is to work hard every day to do our best, to practice preventative medicine as appropriately as possible and to treat illnesses to the very best of our ability, and to understand that the best medicine has to offer sometimes isn't enough, despite our very best efforts...

...but it's easier said than done.


While at a hospice patient's house this past week, I met a woman who reminded me so much of my Grandpaw - she has the same grit and gull and stubborn attitude that helps people live to an old age! I spent some time bull-sh*tting with her; I don't know how else to describe our conversation except full of hilarious banter. I guess she must have liked me, because when we got up to leave she gave me a little Christmas gift. A gold & sparkly scarf...How sweet!!! :)