Before long, I will become, to my patients, a keeper of time. With my long white coat will come the privilege of speaking to a patient who is learning what it means to have limited time left.
Dan and I mimicked ducklings as we followed our senior resident, Tassia, single file down the stairs on our way back to the resident room. As we neared the bottom, we crossed paths with another medicine resident leading two medical students playing the same roles as Dan and I.
“I used to be an elementary school art teacher in San Francisco.” The more he smiled and the more he spoke, the larger the lump grew in my throat. He wore a grayed t-shirt that matched his unkempt black beard.
I found them for you. / Your blonde little girls who grew into women / Then grew apart from you. / I found them.
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?”