Honesty is the Best Policy

In my experience with hospice volunteering in the last 5 months, I have learned more in such a short amount of time than I ever could have in a classroom. As a 20-year old, I am what people might consider “lucky” when it comes to dealing with death. I have never had to deal with a close family member or friend dying, whereas most people I know have dealt with it at some point. This is one of a few things that scared me when I first decided to sign up for the pre-med hospice program. I was scared about how families might act, and how I might respond when faced with death, or even the prospect of death in conversation with someone who was dying. However, through experience and several prompts and thoughtful meetings and videos, I feel that I have better learned how to navigate these situations.

One of my most memorable experiences in hospice came on my very first night. There were 6 or 7 patients on the unit. Most were sleeping, as it was 8 pm when I had come in for my late-night shift. However, there was one patient that was awake and very talkative, and that was Lila. She was small and soft-spoken, likely due to the weakness that her disease had pushed upon her. However, her love for the orange sherbet on the unit and reality TV kept her attentive and happy. We talked for almost the entirety of my shift, mostly about her husband and family. We were able to reflect on happy moments in her life. She told me that her husband was so good at billiards that he could have been a professional. I told her that I only wished I could have been as good as him.

I’ll never forget the feeling of fear and anxiety that I had when talking to Lila, but also comfort and peace knowing that I was there for her. By the end of my shift, she made sure that she had a way for her husband to contact me to teach me how to play billiards. This was so flattering to me, as we had only just met a few hours before, and I had already made an impact on her life. Unfortunately, however, Lila was not on the unit when I went back for my next visit, but that is the nature of hospice.

Lila had been very aware of her fate, which made it a bit easier on me since there was not an “elephant in the room.” We addressed it and moved past it to focus on the good from her life. Although patients in hospice know they are dying, it can still be a touchy subject, which is why I joined this program. I wanted to learn more about the part of medicine that people don’t talk about. The difficult part at the end-of-life stage is that “it”, death, is often ignored. Not because it is unimportant, but because it is so uncomfortable and difficult for all.

Through my hospice meetings, interactions, and reading prompts and videos, what I have learned about death is that honesty is best. In Atul Gawande’s Being Mortal and some of our reading prompts, it is evident that even doctors, the best-trained health care professionals in the world, do not know how to deal with death. Their patients do not know either, and it ends up, many times, in a mess of hopeful lies. Behind closed doors, it seems like both sides just want honesty from the other.

Death is unavoidable for us all, and it is something that we should not ignore. As regular people or physicians, it is something everyone must face. Hospice has reassured me of something I was taught as a child, “honesty is the best policy.” Doctors and anyone talking to a hospice patient should not avoid the fact that they are dying. Everyone knows it. The best choice is to address it with honesty and straight-forwardness. That honesty, in my experience and readings, is just as important as the compassion that we give to these patients at the end of their lives. They do not want pity or grief; they just want comfort and love. By being honest with them, we can open their path to the comfort and love that they need and deserve. Rather than fearing death, we should embrace everything that someone’s life has given them and accomplished while being honest about circumstances rather than running from them. By running from something, there is no way to find peace, and the mission of hospice is to bring peace to the end-of-life.