Death is inevitable.
How we die, though, we can and should have more control over. We are most
fortunate in this country to have Palliative Care and Hospice programs. These
individuals are “angels on earth” as far as I am concerned. They enable our
patients, friends, those dear to us to have that control while being cared for
with compassion and dignity. I am so appreciative of the hard work they do.
Yet, our healthcare system overall is not doing as well in this arena.
In today’s aging, over medicalized, technological
environment with increasingly challenging patient/family expectations, the concept
of dying with dignity has become too uncommon. The highest expenditure of costs
on patient care occur in the last two months of a person’s life and all too
often for futile reasons. Atul Gwande’s book, “On Being Mortal”, provides great
insight into the current state and the high costs, not only financially, but
also emotionally on every person involved.
In 30 years as an
Internal Medicine Specialist, I cared for more dying patients than I can
remember. Some patient’s death, though,
you never forget because of the circumstances surrounding it and the impact it
had on you personally.
I cared for her
husband and her while in the Army years ago. She was dying of pulmonary fibrosis.
She was a woman of strong faith with a loving, supportive family. Her desire
was to die in her home, family surrounding her, with grace and dignity. I had
developed a very close relationship with them both. They were wonderful people.
They had become my friends.
One night, I received a phone call from her husband - she
was near death and could I come by to see her? I drove to their house where I met
him and the three daughters who had flown in from other states to be with their
mother. By the time I arrived, she had died. I remember standing at the bedside
with the family as the husband prayed. Afterwards he thanked me for the care I
had provided her.
That day was the birthday of the youngest daughter. They had
plans to celebrate it with cake and champagne. Then a most remarkable thing
happened. The daughter poured a glass for each of us and led us outside to the
patio. The night was clear and the stars were shining. She lifted her glass to
the night sky and thanked God for her mother’s life and the blessing she had
been to her, the family, and so many others. We toasted her and then we
celebrated her birthday, tears of sadness now mixed with tears of joy. Their
mother, my patient, my friend, had her wish fulfilled.
Moments like this are a reminder of the privilege we have to
be so intimately involved in the lives of our patients. It is a humbling
experience during these sacred moments because of this privilege and the
relationships that result from it. What you do so well every day in the care of
others, is hard work, very hard work. It is important work. Thank you for
caring, serving and loving so well.
Andy Lamb, MD
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