Death: An Immovable Part of Life

Technique, science mastery, and the ability to analyze situations critically are all universal skills taught to pre-medical students in their undergraduate years. However, soft skills like bedside manner, an ability to relate to a patient, and an aptitude for mentally meeting a patient where they are all go beyond the textbook. When asked about hospice, I will point to these skills as pivotal areas of growth during my time in the program. This experience has taught me about my future role as a healthcare provider and has given me a better appreciation for life and death on a personal level. Somehow life is made meaningful by death, and I’ve grown to better understand the two as partners.

Towards the end of my year as a hospice volunteer, I signed up to visit with a patient at a local nursing home. This was my only time visiting someone that I would get to see more than once. Before this point, I’d spent all of my time as a volunteer at Allegheny General Hospital. I never saw a patient at AGH more than once. As a hospice volunteer, this was somewhat expected, but I found myself relieved to have a patient that I could get to know and learn how to best comfort them.

The first time I visited the nursing home, I remember being nervous. What if she didn’t like me? It was only later that I learned that I needn’t have worried. The little Italian woman I visited in that nursing home was a sweet lady, happy to have someone to joke around with. My last visit with her was the Friday that started Spring Break, before things went on lockdown due to Covid-19. I went in because I was scared that, by the time I got back from the break, she’d be gone. During that particular visit she kept asking me to pray that the lord would take her by the next day, and at the time, I had no idea what to say to this. Even now, I look back and wonder if there were any right words I could’ve said in response.

One of the main reasons I joined this program was because I was terrified of death. As someone that planned to be a part of the medical field, it was important to me that I find a way to come to terms with dying. I found myself falling into what Atul Gawande describes as a common mindset amongst physicians: you should be able to fix the problem. The trouble here is that there are problems that can’t always be solved and issues that have no way of being “fixed.” It’s easy to get caught up in the idea of saving someone and forget that death is an immovable part of life. As Dr. Sunita Puri says, life and death are not necessarily ours to change or control. By being a part of this program, I hoped to be left with a better understanding of the importance of the dying process and how it can be viewed as something other than failure.

A large part of the reason I joined the hospice team was because I feared death, but this is not to say that I’m suddenly no longer scared of the uncertainty that comes with death. However, I have grown to better understand the importance of the dying process. A good physician is one that can shift the internal narrative on death to be more realistic when treating patients. This doesn’t mean physicians should give up on patients. Instead, it means that death should be taken for what it is: an immovable part of life.