I followed the Project Leader down the brightly lit hallways of the nursing home, beaming what I hoped was a warm smile at those we passed and anxiously gripping the lanyard hanging around my neck. It wasn’t my first time at a nursing home—I had spent two years volunteering in one during my high school years. However, it was my first time visiting a nursing home resident on a hospice visit. In my high school experience volunteering in the nursing home, it had never occurred to me that some of the residents were nearing the end of their lifespans. Looking back, I realize that the volunteer coordinator might have purposely scheduled us in volunteer activities that only gave us exposure to the most lively of the residents—the singing and game activities, physical therapy, garden walks, and room visits had shielded me from the “darker truth.”
As I stepped into Mary’s room for the first time, I took in the dimly lit room: the pictures of great-grandchildren, the small ceramic figures, the birthday cards with childish scrawls of “LOVE YOU.” When I caught sight of Mary sleeping on the bed, I faltered. I felt awkward and out of place, afraid to break the peaceful silence and disrupt her rest. Reassuring me that Mary preferred being woken up for visits, the project leader called out Mary’s name, gently patting her shoulder. The first visit was very quiet—Mary slipped in and out of sleep frequently, and it was hard to sustain a conversation.
During the second visit, I mustered the courage to hold her hand; terrified by the fragility of her wrist, I let it sit lightly in my palm, too scared to grip it too tightly. Again, the visit consisted mostly of sitting in heavy silence as she fell asleep. The third visit, Mary was much more alert—she enthusiastically talked about her family, and happily sighed while drinking the cold juice she requested. The fourth visit, the silence returned, but it felt lighter; discovering that physical contact alerted her of my presence better than verbal cues, I progressed to snugly holding her hand with one hand while patting it rhythmically with the other, like a mother lulling an infant to sleep. The following visits continued the pattern of silence with sporadic bouts of extended conversation; but unlike the first visit, the silence now felt comfortable, soothing even.
One visit, Mary suddenly said, “I’m leaving soon. I can feel it coming.” Thrown off by the sudden statement, I smiled and softly laughed. But inside, I felt despair. I greatly enjoyed visiting her and had grown used to the routine of seeing her; it was devastating to imagine her gone, and the image brought me unease. The uneasiness slowly went away as the following visits found her in the same condition. Then, the sudden email about her death in the middle of the week shocked me. And for a minute, the world stopped in my mind.
Prior to volunteering with Ascend, the term that I would have used to describe death would be “darker truth.” Like Dr. Puri and the doctors in Being Mortal, I had felt helpless, frustrated that I couldn’t fix the problem—that I couldn’t prevent Mary’s passing. I was selfish—in part, I wanted Mary to live on not for her sake, but for mine. But the more time I spent with Mary and the other patients, the more I listened to their in-and-out conversation, the more I sat holding their hands in silence, I began to realize how foolish and self-entitled my frustration was. I wasn’t there to “fix” Mary—that wasn’t anyone’s role, and it was certainly not mine. Who was I to play God? Even as a doctor in the future, I still won’t be able to go against the laws of nature. Mary herself had been accepting of her incoming passing; what right did I have to reject it? I had stubbornly seen death as an end, as something ugly to avoid rather than a natural process that was beautiful in its own unique way. What’s important is not that Mary was dying—it was to make her as comfortable as possible to the last second. Today, I still mourn Mary’s passing, but rather than lamenting at her passing, I regret not visiting more often, not holding her hand longer, tucking her blanket in one more time, providing the maximum comfort I could.
Hospice volunteering has taught me several valuable lessons: to accept the naturalness of death, the fact that the patient’s discomfort and unhappiness, not death, is the enemy of healthcare professions, and that a savior complex can be a crippling defect in a physician’s mindset. By learning these lessons early, I can avoid falling into emotional pitfalls in the future that can negatively impact my service to my patients, and focus on proactively providing the best care possible with the patient’s best interest in mind, not my own selfish desires.