Before I started my journey as a hospice volunteer, I was already set on the idea of medical school. I wanted to learn how people’s bodies worked, how disease affected them, and how I could save them. In a way, I guess you could say that I had a bit of a savior complex, as most pre-med students do. However, my perspective on medicine and the balance between life and death completely changed during the course of my hospice experience.
Dr. Atul Gawande, a surgeon, writer, and public health researcher, says that the two “unfixables” are aging and dying, and rationally, that makes sense. Despite their unchanging, unfixable nature, we — not just doctors — want them to change. We want people to live longer and to avoid aging longer. That same sentiment is mirrored in doctors when they try to fight death. Their intentions are good; they want to cure their patients and help them live a longer life. For a long time, I subscribed to the same beliefs, but now, I think that it’s kinder and more ethical to approach patients with the goal of making them comfortable and choosing treatments that they feel comfortable with rather than approaching them with the sole goal of curing them. Some patients may prefer to spend their last days differently, especially for patients who no longer wish to stay in the hospital and continue with treatment. Likewise, Dr. Sunita Puri, the medical director for palliative care at Keck Hospital and Norris Cancer Center at USC, says, “the notion that fighting death at all costs wasn’t the sole purpose of medicine.” Rather than forcing patients to continue with certain treatments, a kinder approach would be helping them come to terms with their own mortality and helping them choose the best palliative care for their last days.
I also began to think more about my own health, especially within the aspect of self care. Dr. Puri says, “My parents, both Hindus, had taught me that understanding death as inevitable is necessary to appreciate the meaning and beauty of life. But knowing this didn’t make it any easier to lose patients within days of meeting them.” Palliative and hospice care is difficult work since you’re faced with that thin balance between life and death for many patients, and despite knowing that death is inevitable and trying to be comfortable with mortality, it does wear down on you eventually. Dr. Puri also says, “I’d need to care for myself in order to care for my patients” and I think that this is a particularly radical idea, especially with the state of burnout in healthcare workers today, which has worsened with the COVID-19 pandemic. I used to think that I would work day and night to “save” my patients, but now, I understand that I need to take care of myself in order to continue taking care of my patients in the best way possible.
Ultimately, my experience as a hospice volunteer reaffirmed my desire to become a doctor, but it changed the way I view healthcare and how I want to treat patients. Instead of trying to “fix” every problem, I want to work together with patients to maximize their comfort and joy in their lives.