I was often told that one of the hardest challenges a medical practitioner will face is the death of their patients. A physician must accept that no matter how skilled they are or how hard they try, there will be a number of patients that they cannot save. This grim reality did not deter me from pursuing the medical career since I believed I was capable of dealing with deaths due to my experiences from growing up in an extended family. Prior to joining the Pre-Med Hospice Volunteer Program I was very confident with my ability to interact with elderly patients and was very optimistic that I would handle any losses well. Through the many months of volunteering, I have gained invaluable experience and knowledge that have shifted my perspective and made me truly understand the strength of a medical practitioner.
Death is not easy and I only realized this the day my first patient, “Molly”, passed away. Molly was what we called a “pleasantly confused” patient; she was an 88 years old lady with dementia and no close relatives. My first visit with her consisted of me asking her five questions repeatedly, since those were the only ones she can remember the answers to, and her rejecting my hand massage. Still determined, I returned to her for a second visit, this time instead of bombarding her with questions, I asked her to pose and drew pictures of her. Molly loved it; she would smile and pose without complaining at all. While drawing her, I would ask her questions about her life; the drawing somehow stimulated her memory and she actually remembered stories from her youth. We built a bond quickly afterwards, with her sharing many of her stories. During my last visit with her before winter break, I promised that I would visit her right after I return from my trip to Thailand with photos and souvenirs. She passed away the morning of the day I planned to visit her after the break. I was shocked and grief stricken by her death, but I was even more confused by my reaction.
Molly was not my relative–I had no significant relationship towards her outside of the volunteer program, yet I was incredibly saddened and felt guilty that I was not there for her in her last moments. Even the hospice care training did not fully prepare me for the impact of her death. I wrongly presumed that a death of a patient, while tragic, would not be much different from a death of a stranger. Molly’s death allowed me to understand the difficulty of navigating through death of a patient, something all physicians must face, and highlighted the importance of training for correct grieving response. I still hold her dear to my heart but I know that I did everything I could to provide her with support, companionship and pleasant memories during this last stretch of her life; and I hope to continue doing just that with my other patients.
I am currently visiting my second patient, “Timothy”, and I find that this experience is as fulfilling as my experience with Molly. Even though Timothy is in a much better condition than Molly was, given the subtleness of death, I need to make his end-of-life experience as meaningful as possible. As mentioned, death is not easy, but it should not prevent a physician from interacting with their patient and giving them the emotional support that the patient need.