Death and Dying

This week, for the first time, I spoke with a patient about dying. She has metastatic colon cancer and has fought the disease for a long time but was put on hospice care a month ago. After reviewing her chart, I went to speak with her. Last week she was doing okay, this week she is "ready to go" she tells me. She asks me "how long until I can meet Jesus?" We continue to discuss her family and friends and she tells me she is too exhausted to see them anymore but they keep showing up. We chatted for some time, every few minutes she would ask me to feed her some ice for her dry mouth. As our conversation would pause I realized how at peace she was with this decision she had made, the decision to stop living, the decision to die. In her presence I was surprisingly at peace with her decision as well.

In my life I have had limited exposure to death. In school, when we discussed it I usually became anxious, I would think "this is going to be so difficult and stressful." To my surprise I was completely at peace with this conversation, I was grateful I could be there for this patient to support her through this decision. Speaking to Dr. Addison after I finished my history and physical before he went in to see her, I asked him how he answers the question "how much longer can I expect to hold on?" When she asked me this question I was very truthful, I lack experience and have no idea how to estimate the amount of time a patient will continue to live. He says he decides how much longer he thinks and adds a few weeks.

Throughout my clinical experience I have found many things that are not the way I had expected them to be. In OB/GYN I expected miscarriage to be really challenging for me emotionally, however it was quite the opposite. The times I was most emotional was when parents heard the fetal heart tones for the first time or saw their baby on ultrasound. Their joy filled the room and me, several times to the point of holding back tears. That was unexpected. In pediatrics I spoke extensively with a 12 year old female who was depressed and considering self harm and suicide. She had great family support, but she was unhappy socially. We talked for a long time about friends and by the end of the conversation she was crying and I was fighting hard to keep my tears in check. I know life is never how I expect it, this is what keeps it exciting. I am sure my emotions as a provider will continue to surprise me, and I am okay with this.