I was really nervous when I walked into the dementia unit for the very first time. Even though we had an extensive orientation, I still didn’t know what to expect. But my nervousness disappeared the moment I saw my patient Anne in the dining room. The first word that come to my mind to describe her was “peaceful.” While I expected to meet someone numb or completely unaware of their surroundings, Anne was neither. She was calm, peaceful, and had the most gorgeous smile.
Once Anne believed that we were visiting China, and she told me about her Chinese neighbor. We also had a conversation on the importance of learning a foreign language. Another time, I showed Anne a picture book of dogs and cats, and somehow she thought I was there selling pets to her. She told me about her dogs and cats and how much work she had to do to take care of them. Anne also talked about her late husband all the time. She told me her husband was on a trip, but he would be back home soon. In these visits, Anne might act forgetful, confused, and sometimes a little stubborn, but she was still Anne. Having dementia made her lost some memories, but it certainly didn’t make her lost herself. During these visits, I also realized that the key to communicate with people in hospice is to follow their lead, instead of trying to lead them into a planned topic.
Anne’s energy started waning down after Thanksgiving. It was a gradual process that happened fast. Just like what Atul Gawande described in “Being Mortal,” the human body is like a machine, and when all the backup system failed, the machine will fall apart quickly. Anne started to feel drowsiness during lunch, then she stopped eating her lunch, and eventually in my last visit, she could not leave her bed. During my last visit with Anne, she was lying in bed, feeling uncomfortable, and holding an ice bag on her hand to alleviate the pain. “I feel like something bad is going to happen,” Anne told me. She was anxious, more confused than ever, and feeling very tired. Anne passed away during winter break.
I am very honored to have observed Anne’s final journey. Although it was heartbreaking to see how her health decreased in my last few visits, I also became more comfortable facing the topic of mortality. Anne’s journey was not tragic or sad as I first speculated before I met her, but rather calm, peaceful, and moving. This journey also made me realized that being a doctor and helping people with their health problems does not mean only treating their diseases. The essence should be care for the people. The more I visited my “patients,” the less I want to call them “patient.” I don’t believe we should medicalize the dying process, since it is not about any disease.
Just before I left in my last visit with Anne, I read her the book that’s next to her bed. It was a biography of a priest. She was so calm while I read. It almost seemed like the pain was gone, and I was just reading her a bedtime story. When I finished the preface, Anne said, “This is nice,” and then fell asleep. This is the last conversation I had with Anne, and it is the most memorable moment of my hospice volunteer experience.