Joy to End

Though my entire experience as a hospice volunteer has been a profound learning experience, my first patient was by far the most meaningful. I spent September, October, and most of November visiting June (I’ve chosen this pseudonym as it seems to best describe her character). Previously, I had witnessed hospice living during the late stages of my grandmother’s dementia. Yet, never before had I the opportunity to speak with a lucid person, in the last stages of their life. I remember the first time I met June. At first, she seemed apprehensive, unsure of who I was, and almost hesitant to talk about herself. She asked me questions about where I came from and what I studied. Eventually, she seemed to get more comfortable in my presence. She started cracking jokes with some of the wittiest (and, at times, crudest) humor I have ever heard.

I was perplexed. Some part of my brain could not quite understand how this phenomenon was occurring. June was dying. She knew it and frequently brought it up in conversation. Yet, she had jokes to tell. I fully expected a dreary experience in hospice. Having listened to the reflections of some of my peers, I understand that many volunteers have worked with patients who are emotionally troubled by death. Some part of me imagined death as a ritual somewhat akin to a confession at the Catholic church of my youth: dismal and serious. I expected the end of a life to manifest itself as a void, a somber anticipation of death. And yet, June couldn’t stop laughing and smiling. After telling a good joke, she literally hooted. It felt confusing. I went into hospice thinking I was to entertain sad, emotionless patients. June entertained me. Leaving was always the hardest. She always said something along the lines of, “So soon? I was just getting to the good part!”

June passed over Thanksgiving break. During our last conversation, one week before she passed, she seemed better than in previous weeks. Her death came as a surprise. Death seems like such an anticipated event, and yet, it comes so unexpectedly. June seemed to embrace life even as it came to a close. She was not very religious and, yet, seemed at peace with death. She never seemed daunted by the subject.

I have learned that dying and happiness are not mutually exclusive. I hope to bring this into my medical career and have started to consider working in geriatrics. Healthcare for a dying individual is not always about curative care. Palliative care may afford an individual the possibility of comfort and happiness. This strikes at the motivations behind healthcare. Does medicine aim to cure at any cost? Or is it to provide the best possible life for an individual? I believe medicine is not just a crusade against illness and disease. Medicine is about providing care and comfort. June and her humor, her end-of-life happiness, remind me that death is a in integral part of life; it is part of being human. Dying should not strip away our joy. Until now, I’ve thought that, in medicine, “care” and “cure” mean the same. I now see how the two are so very different. I hope, in my medical career, to provide my patients with enough comfort that they may live to the fullest. I hope they may experience joy, as June did, in the last stage of their lives.