When I first met “Jane,” she was sitting in her chair watching television with the door open. A fellow volunteer who I will refer to as “TheBestesto1” and I introduced ourselves, and she gestured for us to sit on the couch next to her. The conversation that ensued was slow, peaceful. A dog appeared on the television—we asked whether she likes dogs (she doesn’t). A kid fell into a ditch—we shook our heads at his clumsiness.
“I don’t want to watch this crap,” “Jane” announced. We bonded over Everybody Loves Raymond, which I heard secondhand from my parents is a show everybody loves. “Jane” agreed. We sat for a while longer until it was time to see our next patient.
“Next time, we’ll find a way to change the channel,” we promised.
“See you in a week.”
“I’ll be here. Next week and the week after that and so on.” We smiled and left.
In Being Mortal, Atul Gawande describes how aging and dying are life’s two ‘unfixables.’ But comfort, respect, compassion—these are things volunteers, nurses, and doctors can provide. Though terminally ill, “Jane” is just a person who wants to watch some good television. Attending to her preferences and engaging in the dignity of mundane conversation, then, is a small offering—a recognition of our shared humanity. Hospice work has shown me that effectively toggling between the identity of your patient as a ‘patient’ and the identity of your patient as a ‘person’ is essential to being a good healthcare provider. Doctors are taught to practice medicine as the continued act of giving therapy, but when death is inevitable and therapy agonizing, healthcare providers must learn to stop providing in one way (drugs, treatments, procedures), and step up in another. Confronting mortality as a hospice volunteer, or any member of the multidisciplinary healthcare team for that matter, is thus essential to empathizing with the very issues our patients grapple with everyday.
To me, death means to return—to return back to the Earth from which we are borrowed. I choose this definition of death because it offers me some comfort and honors my spiritual beliefs. But I recognize that death may elicit different feelings from different people, especially those faced with their own mortality: perhaps confusion, loss, injustice, ‘the end,’ or ‘the beginning.’ Trying hard to understand these various, even contradictory, definitions of death and reckoning with a patient’s pessimism as well as peace can result in compassion fatigue for the provider.
As an aspiring physician, I believe that hospice volunteering has been invaluable for developing strategies to cope with the challenging, unglamorous realities of medicine, to manage compassion fatigue through self-care, and to practice reflecting and meaning-making. Each visit may be uneventful but they sum up to the privilege of witnessing someone’s life. It is an honor to share space with someone as they ask themselves difficult questions and live through their final weeks and months. It, too, is an honor to help make this experience as close to ‘living’ as possible, by offering comfort, company, and respect—the dignity of mundane conversation.