Recognizing Death

Throughout hospice volunteer experience, I had many meaningful connections with my patients. The moment that I find the most memorable was when my coworker and I visited Michelle, a recently-admitted patient.

When we knocked on Michelle’s door, she was obviously agitated. She immediately asked us what was going on. We told her who we were and what we were doing there, and we informed her that she was currently spending time in the hospital. We didn’t know why she was there, and we had no knowledge of her health or prognosis, but she took comfort in our calm demeanor.

We asked Michelle if she would like us to stay, and she declined, but then asked us to sit. We spent time with her watching the hockey game on the television, discussing our backgrounds, and even making jokes. Eventually, Michelle started to laugh along with us, and although she wasn’t entirely at ease, it was clear that she began to warm up to us. When her food was brought in, she offered it to us. She told us that she loved cantaloupe, and the conversation turned to food until a nurse came in and asked us to step out. Even though we were not able to spend a lot of time with her, we felt as though we had formed a meaningful connection with Michelle.

I believe that this experience has improved my ability to talk to and interact with patients, an important part of medicine. When she asked what was going on, it was difficult to not immediately try to comfort her with false promises, as many medical professionals and doctors are tempted to do. However, knowing everyone will die and that patients in hospice are usually in end-of-life care, it was important to me not to propose the false idea that nothing was wrong and that she would go home soon, and furthermore, to internalize the thought myself.

This program exposes prospective medical students to the fact of death. Death is not an easy thing to deal with. As future doctors, our instinct is to save everyone, regardless of their prognosis, and to reassure patients that we will succeed, but this is not ideal. Every single patient (and doctor, for that matter) will die. There are no combinations of treatments that will prevent the inevitable, and the desire to ignore this fact is harmful to the doctor and to the patient.

Participating in hospice and palliative care forces people to accept the knowledge that medicine is not infallible. It has given me a new respect for medicine, including its advancements and its limitations. As a result of this invaluable experience, I have more realistic expectations and better skills to discuss those expectations with colleagues and patients.