When I first considered being a hospice volunteer, I had little experience with death. While I have lost family, much of it was when I was younger. I have experienced death within the healthcare system through shadowing in the ER. But I didn’t understand how complex death becomes within a relationship of care. Not just emotional care, but physical too. How connections that form from care, no matter how brief, are lasting.
Throughout the last year, I have only had one patient. To respect his privacy, I will call him “Joe”. Recently, he passed away. While in choosing to enter hospice, I had an understanding that any relationship formed would be tied to the transition between life and death, and that anyone I cared for would die. Still, “Joe’s” passing was a shock to me. Within his care, I knew on some level that he was approaching death. He was having more trouble walking, relying on his chair, and the few steps back to his bed winded him. As I saw him over time, these symptoms only got worse. Yet, despite his illness, he was always kind. His advanced dementia meant he didn’t always know why hospice volunteers were visiting, but he was never agitated, only curious. When we sat with him for breakfast, he often asked where our food was, and he was only reassured after we told him we had already had breakfast before seeing him. When we left him after a visit, he would always tell us to stay out of trouble. He would tell us stories from his own college days, and we would tell him college stories of our own.
On our last visit to see “Joe,” it was clear he was nearing the end of his life. He was bedridden, struggling to speak and stay awake. He had no memory of the people who had visited him earlier in the day, and clearly didn’t understand who we were. The few conversations we had were addled; he asked to put his glasses on, but I’ve never seen him wear glasses before. We helped him put on his watch. We got up to leave, and he asked us to stay for 5 more minutes. It was clear he was going, which made it even harder to leave.
While I did not know “Joe” before his illness, my role in his care formed a bond that I did not fully appreciate until he passed. His death made me reconsider the emotional toll of being a doctor and how care shapes the burden of loss. When he passed, I was devastated. But I also gained a much greater appreciation for those who work in hospice and the importance of end-of-life care. I am so grateful to be a part of “Joe’s” life, despite the grief I feel over his passing; it does not shake my commitment to hospice and to becoming a physician. Being a hospice volunteer is an invaluable experience, illuminating the importance of palliative care, but also the flaws that still exist in the healthcare system. It has been one of the most challenging ways I have interacted with the healthcare system thus far, but also one of the most meaningful. This experience has changed the way I consider hospice, care, and the life-death transition, and will pave the way for me to continue to interact with the healthcare system, for medical school and beyond.