I wanted to volunteer for a hospice program after reading Being Mortal by Atul Gawande. Before reading that book, I believed that a good life was a long life and that the role of doctors was to extend the life of their patients. I had never considered what a good death was or what it meant to me. Reading Being Mortal felt like the axis of my world was shifting. I recommended the book to everyone I knew, because of its exploration of how America treats its elderly and especially how the US medical system views death. I decided then that I wanted to be a geriatrician and volunteer or work in a hospice program. When I was offered the opportunity to volunteer through Compassus, I was thrilled and jumped at it.
When I started volunteering, I did not know how much I didn’t know. While I didn’t recognize it at the time, I expected that I would see concrete evidence that I had helped a patient and that the patient, or their relatives would be grateful and happy that I was helping. These illusions were selfish and proved wrong in my first visit with a patient, who I’ll call Jay. In our visits, Jay was extremely tired and had difficulty speaking. When she would talk to me, she would often forget what she was saying mid-sentence or drift asleep. It was not what I’d expected, and I was disappointed in myself. I kept telling myself if I was better, more entertaining and more talkative, she would talk to me. I thought, because we weren’t talking, that I could not be helping her. It took about two months for me to realize that I needed to change my expectations, both for what I should be doing for her and what a beneficial social interaction was. Even if we were not talking, it was nice to sit next to each other. I would knit and we would watch a movie, or I would tell stories about my life. She really liked how soft my yarn was, so I brought her a pom-pom I made from the yarn. When I let go of my expectations, I was able to have visits that were more fulfilling for both of us.
Through hospice I learned to accept my situation and the situation of those around me. Struggling to create a situation that I viewed ‘normal’ was frustrating for both of us. I want to take this lesson with me as I pursue medicine. Both that I need to be flexible, but especially to acknowledge my ignorance. In “The Lesson of Impermanence,” Sunita Puri talks about how when she became a doctor, she thought she was prepared to face death, but still found the experience emotionally draining. If I had not gone through this program, I would have approached a career in medicine with a similar attitude and belief that because I knew that death wasn’t always something to avoid, that I could be a good doctor. That article and this experience taught me that theoretical understanding cannot compare to emotional realities. To help future patients and myself, I want to hold this awareness of my ignorance and willingness to learn and adapt.