Growing up, I had only been exposed to one particular physician image; the hero doctor. As a child, the carefully constructed representation of physicians as miracle workers was very appealing. The doctor was the champion of life, prolonging it and saving it, always resulting in smiles and joy from families and patients. I desperately wanted to be an integral part of health care treatment, to make a positive difference in the lives of my patients. The opposite connotations of life and death were so obvious, but at the same time, they were never explicitly said. It seemed clear that death was bad; that woven into the goal of ‘prolonging life’ was the goal of ‘preventing death.’ And in the movies, it was really ‘preventing death at any cost.’ The simple dichotomy of life as good and death as bad is a general theme that infects our everyday lives. For me, I had never been forced to unpack the intricacies of this dichotomy, discover that it was not so simple, until I starting volunteering with a hospice organization and met Debbie Larson.
The first day I met Ms. Larson, I was extremely nervous. At the volunteer orientation, the hospice organization had tried to give us new conversation tools in order to talk about death. I had not realized it until the moment, but it occurred to me that I had not actually had a verbal conversation about death with anyone. This realization was a bit startling and embarrassing. Had I really gone through my entire education thus far, wanting to be a doctor, but not thinking even a little bit about death? When I met Ms. Larson, I was nervous because I could not stop thinking about the sadness and negativity of death. Ms. Larson had been diagnosed with Aortic Valve Stenosis, which had left her bed-bound, and she was already beginning to rapidly decline when I met her. The facility she lived in was over crowded and Ms. Larson shared her room with two other patients. I remember thinking to myself that the living space seemed even worse than the dorm rooms. After introducing myself, Ms. Larson and I talked non-stop for the duration of the visit. We talked about her growing up outside Philadelphia and about her son who worked at Haverford College.
When I left, I was surprised about how easy it was to talk with her. She had been with the hospice organization for a while and told me that being able to meet new people was one of her most favorite hobbies. As I was walking back to my college, I thought about how it is so easy for me to be surrounded by new people. While continuing to visit Ms. Larson every week, I learned a little bit more about her life. She desperately wanted to give me advice and every little story she told had a little piece of advice added to it. Every so often, she would add a comment about how she was feeling pain, or how she was waiting for the end to come. All I could say every time was, “Don’t worry,” and she would respond, “I’m not worried.”
Ms. Larson’s health began to decline rapidly, and in our conversations, I began talking more and she began talking less. I updated her on my life every time I visited, and during the last couple of visits I had with her, she just smiled at what I had to say. Different from before, it seemed as though she knew death was coming. What surprised me most about Ms. Larson is that she did not seem worried about death at all. She didn’t pretend as though it didn’t exist, but it also wasn’t the only thing on her mind.
Through my experience volunteering at the hospice organization, I realized how detrimental it was for death to always have such a negative connotation. Because I had always seen life and death as opposites, and the positive connotations that came with life also implied that death had to be negative. Ms. Larson’s almost indifferent view about death showed me that I could still help her without having to prevent death from coming. The only reason Ms. Larson, and most people, are in hospice was being medicine was not able to prolong her life, but that didn’t seem to be her goal anyway. I learned that death is part of life; preventing it should not be a foundation of my goals as a doctor. I want my goal to be to provide the best type of life for my patients, where prolonging life can be one of many ways to achieve that goal.