We treat patients, not diseases.
All healthcare flows through the relationships between the healthcare provider and patient.
The spoken language is the most important tool in medicine.
Do not stand at my grave and weep,
I am not there; I do not sleep.
I am a thousand winds that blow,
I am the diamond glints on snow,
I am the sunlight on ripened grain,
I am the gentle autumn rain.
When you awaken in the morning’s hush
I am the swift uplifting rush
Of quiet birds in circled flight.
I am the soft stars that shine at night.
Do not stand at my grave and cry,
I am not here; I did not die.
For weeks, a patient had been ambivalent, struggling with the decision between full medical care or comfort care only. It was only a matter of time between the disease would make that choice for her.
Everything we could do to prolong her life had been done. There was no process left to reverse. The disease was reaching its ultimate conclusion. With great reluctance, the patient agreed to comfort care.
It pained me to see her struggle because I knew how much it chewed her up inside, to leave behind her family and friends, to be confronted with the threshold of death. It was obvious she loved dearly and was dearly beloved.
I saw her briefly again today after finishing my rounds, passing through our hospice. After seeing her struggle for so many weeks with this decision, I was relieved to find her smiling, having finally found peace in these last hours, surrounded by friends and family. As they gathered to look at old photo albums and share stories under the warm winter glow, her eyes flickered with joy as she laughed with her grandchildren.
For a moment, our eyes met as she caught a glimpse of me by the nursing station. Quietly, we acknowledged each other.
A reader asked me what hospice means. To understand hospice, I need to discuss its purpose.
Hospice care is very specific to a terminal patient. It involves palliative or ‘comfort care’ for life-limiting illness rather than curative treatments. It involves professional medical care, advanced pain and symptom management, and emotional, spiritual and practical support based on the patient’s wishes and family’s needs. In Canada, the terms ‘palliative care’ and ‘hospice care’ are often used interchangeably. The word ‘hospice’ is sometimes used to refer to a home-like place where people spend the last days or weeks of life.
Please do everything. I do not want to die. I am not ready.
It is the duty of a doctor to prolong life. It is not his duty to prolong the act of dying.