I’ve been dreading my rotation at the hospice. I have a tendency to empathize a lot, maybe too much, with everyone that I meet so I was concerned that going to the hospice would be a really tough experience for me. I was worried that I wouldn’t be able to stay tough around so many terminally ill patients and that I would break down and cry in front of my peers. I expected the hallways to be filled with sobbing families and the rooms filled with patients dying painful deaths. I prepared myself for the very worse (and even stocked up on chocolate for when I returned from hospice).
The hospice that I saw was very different from what I expected. The center is situated on the lake, with beautiful landscaping, and gorgeous patient rooms. I felt that the place was very calming with open spaces and fresh flowers. I was impressed with the way that the staff dealt with death. I imagined that the “D-word” wouldn’t be mentioned, especially in front of patients. Instead, I was surprised to see how openly the patients and staff discussed death and dying.
As a physician in training, seeing a patient die is something that I’m not quite sure how I would be able to handle. So much of the medicine that I know is about learning about the problems of a patient and “fixing” them. A recommendation to stop trying and move on to hospice care seemed so much like giving up. Although I still don’t quite know how I would approach the subject of hospice care with my future patients or what point would have to be reached in order for me to make that recommendation, I discovered that hospice care was such a dignified way of approaching the end of life. Instead of ending their lives hooked up to countless burdensome machines and experiencing awful side effects, the patients at hospice seemed to live their final days to the fullest. Lifelong diabetic patients enjoy cookies while other patients learn how to sail for the first time. Although I recognize that it must be incredibly difficult to admit that a person’s life is really coming to a close, hospice care seems like a very empowering option for the patient.
I spoke with two patients at the hospice. One of the patients really opened up to us. He seemed really grateful for the hospice option, despite how costly the stay is ($6000/month!). Although he seemed to accept why he was in the hospice he told us how much he struggled with his family’s reactions when they visited; he hated seeing how much it hurt them to have a terminal illness. Some of the advice he offered: “Live life like today’s your last day, learn like you are going to live forever,” “Don’t waste your time worrying about things like money; you never know what’s around the corner.”
Although “hospice” has a negative connotation, I wish that I had known more about it before my grandfather passed away. I wish that this had been an option for him. Like one of the patients that spoke with us, his health was fine until one day it wasn’t. Instead of being incapacitated in a hopsital, I think that my grandfather would have preferred to pass with more dignity and control. Hospice care addresses death as something that we all experience and gives the patient control over their final moments.
