My first encounter with the Hospice Volunteer Program started with a topic relating to the first fear and anxiety that all doctors have: unable to fix a medical problem. As an individual who is interested in pursuing a career in healthcare, I have the same stereotypical thought that doctors are supposed to “fix problems” and ease the suffering of all patients. Than I watched the introductory video to the hospice program Being Mortal. Ironically, my passion for being a physician sparked as I wanted to make a difference in the Asian American community’s lack of focus on mental health problems both due to cultural influence and hard to access healthcare, which is another way of saying “fixing the problem”.
From the video, I learned that there are two things that can’t be fixed — aging and dying. Though it is hard to admit, time only goes forward and aging is a byproduct of time. From an evolutionary standpoint, there is only life when there is death since the resources on this planet are scarce. Without death, the population of the planet can’t be supported with the restricted resources that are available. Even though death can not be avoided, the job of a doctor seems to be fighting death which frankly speaking, is impossible. I learned that the death of a patient is not necessarily a doctor’s failure. As Dr. Puri mentioned in The Lesson of Impermanence, “the notion that fighting death at all costs wasn’t the sole purpose of medicine”, I understood the doctor is essentially a service professional and it should be the doctor’s goal to listen to what his/her patient wants and facilitate them in achieving their goal. Especially during times when current medical knowledge isn’t about to provide a quality life for the patient.
Sometimes, the doctor’s goal and the patient’s goal might not align. For example, a doctor wants to elongate a cancer patient’s life with more radiation treatment, but the patient does not want to suffer the side effects of the treatment anymore and he/she just wants to be comfortable for the rest of their lives. This is when hospice care comes into play. As important as it is to care for the living, the wishes of dying people should be granted to a realistic extent. Dying patients also have the autonomy to determine the direction of their treatment and the deviation of any decision from his/her loved ones should be recognized and addressed.
Hospice provides the patients’ end-of-life care with the principle of allowing them to be as comfortable as possible. This year due to COVID, I was not able to go into a hospice and interact with a patient. I trained as an EMT this past winter semester and was able to transfer a few patients to hospice care during my ambulance clinical. I was able to see the hard decisions that their families have to make and I also held the patients’ hand during transfer to provide support. At the moment when I held hands with the patient, instead of pure sadness, I have the strange feeling of being happy that the patient’s wish has been fulfilled despite the potential sorrow that is going to be put on their families’ shoulders.
I hope when I return to the hospice program as a senior this fall, I am able to volunteer at a hospice and put my knowledge about the process of dying to work. I believe understanding and helping with the needs of dying patients will make me be more appreciative of the beauty of life as a future physician.