In the beginning of my hospice volunteer experience, my sole aim was to develop connections with patients. As my time as a volunteer concludes, I realized that I never want to stop doing just that—giving all of myself to the patients I care for.
My very first patient was an older woman diagnosed with Alzheimer’s. Each week, I would sit with her as she told me stories about her time as a bartender, her children and grandchildren, and her beloved husband. There was no goal to my visits other than to provide her with companionship in the months that she had remaining. Knowing that her birthday was soon, the care team and I planned a party for her, complete with cake, music, and her family. As the celebration was about to begin, we realized that the other patient in the room had entered into what would be her final 24 hours of life. In this moment, we were trying to celebrate one more birthday for my patient while simultaneously realizing that this other patient had already had her last. Hospice care centers around honoring the life that is remaining, but concurrently coming to terms with the fact that life is finite. On that day, I was able to see the dichotomy of hospice care—the joy of holding on in the smile of my patient and the tenderness of letting go in the eyes of patient one bed over.
When I arrived the next week, I looked at the empty bed next to my patient’s. My heart was able to feel peace, rather than the sadness we tend to associate with death. The patient had died in a beautiful way, surrounded by her family and enveloped in her favorite music. I turned to my patient, and, as always, she did not remember who I was, but she recalled the party and the joy she had felt knowing that others had went out of their way to make her feel special. In this first experience as a volunteer, it was challenging to develop a relationship with her knowing that she would not recognize me each week, but I am sure that in the moments I spent with her, I was able to make a difference. We may have started each visit with a re-introduction of who I was, but we ended each one with her telling me to visit again as soon as I could. As small as this may seem, this is why I want to be a doctor, to leave each visit with the patient confidence that I am there for them, one moment at a time.
Even before my experience with hospice, I was aware that the only certainty in life is the end of it. Life is temporary and determinable, but death is permanent and inevitable. I think in a lot of ways, we think of death as the antithesis of life. But through my volunteer experience, it has become clear to me that death may not be the opposite of life, but simply the conclusion of it. Life is a time to change what we cannot accept, but death is a time to accept what we cannot change. I think the hardest thing to comprehend is the dichotomy between the certainty that death will happen and the uncertainty surrounding the circumstances of death. Death is the one experience on this earth that no one else has gone through themselves, but everyone will. This unifying equalizer and the beauty that can be found in the end of life suggests to us that death is not bad simply because life is good. After this experience, I have truly begun to see death as the finale of life.
As we have read and seen throughout previous reflections, doctors are taught to associate death with failure, but I think it is clear that the conversation around death in the medical field needs to be reframed. In the final reflection, there was one quote in particular that stuck with me: “What makes us suffer is wanting things to be permanent when they are not.” Medicine aims to provide care and reduce suffering, but in reference to the quote, suffering is not just physical. If medicine is going to effectively and comprehensively comfort patients in the end of their lives, medicine must go beyond simply avoiding death. As a future physician, I feel that this program has given me comfort with the end, which is a skill that seems to be undervalued in the current climate of medicine today. I have grown in my ability to be reflective about the larger questions surrounding quality of life and to interact with patients in the most sensitive moments of their lives. This exposure to the difficulties and complexities of medicine, alongside the experience of caring for those whose time is limited, has confirmed to me that this is what I want to do for the rest of my life. If I can spend each day feeling that a patient is receiving comfort and companionship from my care, then I am certain that I will find fulfillment in my work.
Overall, this hospice volunteer experience has immensely affected me by allowing me to grow not only in what I want to do professionally, but also in who I am personally. I am so grateful that I have had this experience, and I look forward to using all that I have learned by continuing to impact the lives of my future patients.