To physicians, hospice frequently symbolizes defeat. Referring a patient to hospice care can feel like admitting that disease has defeated years of training. In medical school, we are trained that the role of the doctor is to fight the disease and find the cure.
At 7:21 p.m., I arrive at the hospital for the first overnight shift of my medical career. It’s not a great start — the bus was late, and I didn’t sleep nearly enough this afternoon in preparation for the night ahead.
Tears hold onto the ledges of her eyes. As the physician and I approach, a quivering begins. It emerges at the jaw, a flutter running across her lips, only to drop onto her shoulders and envelop her hands.
He was sick, but it wasn’t like he was going to die anytime soon. A year ago, my dog Sierra sustained a neurological insult that left him delirious, unable to walk straight and almost entirely blind and deaf.
Never grow old she says, / As the IV beeps and her SCDs hum. / Enjoy your youth she says, / As her body creaks and her fingers drum.
“There must be a better way to make a living than this!” / Slam. / Silence, except for the persistent heartbeat. / The beat of the ticking time bomb, the dying heart.
Palliative. End of life. Dying. How do we care for patients at this stage of illness?
I’ve heard it said that knowledge is power, and that to be forewarned is to be forearmed. I still remember getting a text from my mother when I was on my OB/GYN rotation, during the first window of time I had gotten to use the bathroom all day. I remember her texting me a picture of a CT scan of my grandfather’s lungs with the words: “What does this mean?”
I spent the first week of my outpatient experience in internal medicine working with the nurses at Hospice of the Red River Valley in Fargo, ND. Besides being incredibly nervous to begin my third year of medical school, I was anxious about what I might encounter on my week at hospice.
In the playbook of professionalism, / Where is room for the physician who / Reads German poetry to the dying patient / For days and days until her end?
My alarm went off at 4 a.m. in the morning. I begrudgingly pulled myself out of bed, threw on some scrubs, and headed to the hospital. Not a car was on the road. It was the third week of my OB/GYN rotation, and I was on the infamous gynecologic oncology service.
I awoke to a phone ringing frantically, must have been a Whatsapp call. My father yelling from downstairs, “He passed.” And my mother, opening my bedroom door before my eyes had fully opened, stood there with her cellphone out, lips quivering, and eyes searching, “He’s gone.” My grandfather had passed away.