A disease is a whole, because one can assign it its elements; it has an aim, because one can calculate its results; it is therefore a whole placed between the limits of invasion and termination.
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.
I am sick of the pink. This is not pink. Pink is not breast cancer. Look at me. This is what breast cancer is.
I stood there and did my best to explain what we felt was going on, our impression of the possible causes, and our investigations around them, some of which simply could not be done tonight.
The family was not satisfied. “We want answers. Now.” From there came the questions. “Why must it happen later? Why is this test being done? Why will you not take our complaints seriously?”
I reassured everyone that we were checking every avenue, that there was a method and reason behind the tests and explained as plainly and thoroughly as I could. More importantly, I tried to address their concerns up front and with honesty.
Nothing could appease my audience. I could feel the growing dissatisfaction in their tone, the tension that my presence brought to an obviously well meaning and concerned family.
However, standing there, the focus of every pair of eyes in the room, I began to feel the churning of my stomach, the pounding nudge in my chest, and the burning flush of my face. I had become an enemy in the room, an obstacle between the vocal family who wished to be heard and heard by none other but the doctor himself. It was time I excused myself.
I returned quickly to my attending and explained the situation: I had attempted my best to alleviate their anxiety and answer their questions but I had failed. I needed help.
When he arrived, even then the discussion presented challenges. It took a lot of work to come to an agreement and understanding.
The communication channel is open both ways. The solution to defusing a situation like this is always to make people feel that they have been acknowledged, that their concerns have been understood, that they are not an afterthought in this already complicated system of care. Even with that in mind, the discussion can be challenging. It really takes a lot of patience, perseverance, and thick skin to build up the rapport needed in difficult situations.
Perhaps with time and experience, I can find a way to finally manage this myself. For now: please do not shoot the messenger.
Were you ever involved in a confrontation? How did you deal with it?