I used to think that I was drawn to hospice practice because I wasn't one of those doctors that had to fix everything. I'm comfortable with the incurable, the insoluble, the chronic and unremitting. I don't see death as a failure of my medical skills. Nope, not me. I'm not like that. I don't have a personal need to cure.
Except....I do still have a need to fix things. I don't feel compelled to cure; I feel compelled to relieve suffering. I need to make pain go away, ease shortness of breath, make the nausea stop. I need the furrowed brow and the tense muscles to relax. I need to make things better. And most of the time we can. We have morphine and humor and steroids and Haldol and ice packs and Ativan and massage therapy and music and pets and chaplains and social workers and aromatherapy and our own presence. When our patients are suffering, we can bring comfort.
It's more challenging to bring comfort to the families. Pain goes away. Grief must be borne. We can provide some companionship and support; in the end, though, grief is a solitary journey. A husband's tears or a daughter's anxiety leave me feeling powerless in a way that the patient's pain and shortness of breath do not. I want to do something, and I know I just need to stand there.
Today was a little different. Today, oddly enough, two different family members needed something I could give them. Something simple and available and entirely over-the-counter. They needed water. Twice this afternoon, I walked down the hall to our ice machine and filled a cup with ice and water, carefully placed a lid on top and collected a straw. I brought the cups back to the quiet rooms and placed them in the waiting hands. And I felt much better.
What a beautiful and practical way to consider comfort. You can always do SOMEthing. :) - Amanda
ReplyDeleteAnd this is why you are such a good doctor and human being.
ReplyDeleteIn reality, I bet you do more for the families of your patients than you do for the patient's themselves. How much comfort you must bring them knowing their loved one is dying in the most humane and comfortable way possible? And that memory stays with them, including the gratitude they feel for an eased passing. The person who passes, their suffering is eased, and then it is over. The families of those patients carry that comfort with them for the rest of their lives. I think you underestimate the value of what you do for your patient's families. And you underestimate most people's savvy. Most people have seen others pass with prolonged suffering. If your patient's families experience something else, they understand how special that is. I hope you do too!
ReplyDeleteI agree, I think you're selling yourself short. It's hard to know the impact you have on the families of your patients because often there's no follow up, but I am sure you're a greater comfort to them than you are giving yourself credit for. It's hard for people who are grieving to express their gratitude for the service you provide, but know that what you do does help.
ReplyDeleteThank you. We actually do get some followup (we have surveys, like everybody else these days) and we also, unfortunately, have families come back sometimes with other loved ones. I have some sense of the value of what we do - what *I* do. In the moment, though, they don't look more comfortable (of course). I also know that this is my stuff; they don't owe me anything. Writing about it is one of the ways I cope, so that I can go into each encounter as fully present as possible.
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