Participating in the Holisticare Hospice program this year has been a wonderful experience. I have never been part of a community devoted to the art of dying and death and it has given me a new perspective on how the dying are cared for not just physically but also mentally and emotionally.
My preconceptions about medicine include that medicine and doctors aim to heal at all costs. There is always another treatment that a patient might be willing to try, but it is up to the patient to decide when their treatment should reach an end and natural events should be allowed to occur. After reading Atul Gawande’s Being Mortal, suggested reading material for hospice volunteers, I now think, and have experienced, differently. Entering hospice is ultimately the patient’s decision, but that does not mean that a physician cannot suggest palliative care. When someone is dying and treatment options aren’t working, the focus of their shortened future turns not to how many months they have left, but how to make their remaining time the most comfortable and dignified as possible. This is where traditional medicine and hospice, particularly hospice volunteers, intersect. Being a hospice volunteer has taught me to think about my “patients” as people and to be a friend and not someone poking and prodding them, dressing them, feeding them, bathing them, or changing their prescription dosage. My obligation as a hospice volunteer is to support the emotional and mental aspects of being human, to listen, and to be a friend.
Throughout this year, I have been able to visit with one patient for an extended period of time and I have grown quite fond of our hourly visits on Sunday. It brings me joy to see her smile when she sees me walk into the room and call her name. She repeats many of the same fabricated stories to me, but these visits have taught me “to go with the flow” and to make my patients feel heard and important no matter what they say. It’s very important to me to remind myself that she is a person who has similar fears and aspirations and not just “someone” who is dying. Hospice is as much about emotional care as it is physical care. Being a hospice volunteer has shown me the value of being present. Being present doesn’t mean filling every moment together with talk and chatter, but rather occupying a physical space and offering companionship in whatever form it may take. Accepting that sometimes silence is enough for both you and the person you are experiencing this phenomenon with has shown me how important it is to show someone in hospice you care rather than actively saying it. The importance of presence cannot be understated in hospice work, even if presence is a transient condition. Through this experience, I find myself continually reflecting on how valuable it is to be with your patient for however long you spend with them because their time is limited. That chemistry exam you have in 3 days is not as important at that moment as offering your full attention to make a dying person feel heard or comforted.
I have been very fortunate to have experienced very little familial death in my life, but coming face to face with people who are dying every week, people I now care for, has shaped my thoughts and ideals on death and dying. Death is a natural part of life and eventually we all die, but that doesn’t mean we have to suffer alone in the process and that it’s taboo to talk about death. Compassion and the act of being present are perhaps the two most valuable things I have learned through hospice and I hope they remain with me always.