A couple years ago, I picked up Atul Gawande’s book, Being Mortal, on a whim. I was looking for something to read on the train on the way home for Thanksgiving. I started reading the first few pages to see if I liked it, and ended up reading in the library for over an hour and finishing the book before I even left campus. As a pre-med student I knew death was an important aspect of the practice and my future career but Gawande’s honest and thoughtful reflections on the dying process gave me a better understanding of the role death would have in my future.
As the average age of people in this country increases, end-of-life care is only going to become more prominent and important. I learned from Gawande that it is important to have conversations about dying and what people are willing to give up and what they are not. I learned that it is important to have these conversations early and often. I thought going in to this program that it would be an amazing opportunity to learn more about, experience in person, and reflect on hospice and end-of-life care to better shape my capacity to care for patients as I go on to medical school and enter the profession. I also was excited about the program because of the personal connections I would be able to make with one or two people that I would visit with weekly. This last part turned out to be the part of the program that would most inform my views on hospice, life, and death.
The two women that I would get to know over the course of the year were brave, sweet, intelligent, and inspiring. Each visit was completely different and also the same. We talked about the same memories and stories of their lives but in different contexts. Some days they knew who I was and sometimes they were meeting someone new. Some days the stories came from a place of fear and sadness and other times it came from pride and celebration. I learned that time takes on new meaning in a hospice setting and that I should never get used to a particular state of being. I learned that conversation, touch, and companionship is different for different people and under different circumstances. I learned that death is not necessarily an end and can cause fear one day and comfort the next.
As the end of the program gets closer, I am reflecting more on how my experiences have influenced and connected with what I have read in Being Mortal. Gawande writes, “The battle of being mortal is the battle to maintain the integrity of one’s life — to avoid becoming so diminished or dissipated or subjugated that who you are becomes disconnected from who you were or who you want to be”. I see this manifested in the women I now consider role models. I now understand how choosing hospice allows these women to maintain the integrity of their lives. Instead of choosing the widely accepted path of being subjected to a narrow minded industry where the goal is to extend life, they have chosen a path where life is upheld and fulfilled.