Hospice and Me: A Reflection on Patient Encounters

Dr. H struck me as a very sweet-tempered and genuinely caring person when I first met him. This has not changed as I have gotten to know him better. When his eyes light up at the mention of his wife coming to visit, or when his voice speaks of his children’s achievements with a father’s pride, I see the ubiquitous family man. Dr. H never quite sits still. It is not unusual to hear him speak of a conference he attended, or see him trying to leave, stating “I have to go” with a sense of urgency. In these moments, I begin to understand the frustration of being confined to a wheelchair and having people tell you about the status of your health, especially when you have been a physician longer than some of them have been alive. It is not easy to transition from a busy caretaker to a dependent care-recipient.

I also regard Dr. H with a level of curiosity. I cannot imagine what it must be like to go from being a physician – intelligent, busy, and authoritative – to being a hospice patient where you depend so much on others to care for you. Your autonomy is limited and your memory fails you often. I cannot help but wonder, if there were any signs of mental decline when he was practicing, or if a patient got hurt before they realized that the doctor was not 100% himself. Even so, Dr. H is a living reminder for an aspiring physician like myself that illness and death are respecters of none. Dr. Dhruv Khullar captures this idea well in “We’re Bad at Death. Can We Talk?” when he writes, “Despite a popular misconception, doctors don’t die much differently: Physicians use hospice care and die in hospitals at rates similar to everyone else.”

Visiting Dr. H makes me feel like I am already a part of the health profession. I feel a small sense of pride and duty when I turn down something with the phrase, “I can’t, I have to go and see my patient.” That word, “my patient,” inspires in me a feeling of tenderness that I hope to share with many more in the course of my career.

Yet, I did not know that my experience in hospice would come in handy quite soon. A few weeks ago, my grandfather died. I called home the day he was rushed to the hospital in an ambulance – the day the doctors gave him a 10% chance of survival. Despite all I knew about DNRs and quality of life at the end of life, there was still a part of me that wanted him to hang on, even though I had personally witnessed how hard it was for him to get by every day. I realize now, that even with training and practice, no one really ever gets used to death.

Through these experiences, I have come to the conclusion that for all the lives that I am determined to help save as a physician, I have to be ready to deal with the lives that I cannot save. To have had the opportunity to prepare for that through hospice is invaluable. For this, I am grateful.