I never dreamed at the beginning of my career that I would end up in Palliative Care and be a Hospice Medical Director. The journey from medical school to where I am now was punctuated by many challenging patient encounters, as well as personal losses, which not only opened my eyes, but also deepened my compassion for those around me.
Part of my medical education - like many physicians - was about how to become detached from my patients. This wasn't a particular course or curriculum - it was taught by example. My first medical residency in Australia was in a very large teaching hospital, and the underlying message was that it was "us vs them" - in other words, don't become emotionally involved in your patients or their family members. Perhaps it originated from a primal fear of catching our patient's illness (even when consciously we realized that their non-infectious disease was not contagious). Maybe dealing with serious illness meant we had to face our own mortality.
Fortunately, I was never good at being impersonal. This style of medicine was not for me. This realization did lead to introspection and I was forced to ponder my own answers to the big questions. It also taught me to figure out how to balance my work and home life and how to best take care of myself so that I can take care of my patients.
Over the years, my life has been greatly enriched by the many patients and their family members that I have encountered. I have been privileged to enter that "sacred space" where people have shared their greatest hopes and fears and helped them make those difficult decisions. What is truly important becomes clearer in the face of serious illness. Once symptoms are controlled, most people want to spend time with their loved ones and family. Maintaining independence and control over what happens on a day-to-day basis is highly desired by most people.
Overall, these dear patients and families have taught me how to keep perspective and how to live life one day at a time (while still planning for the future). I have learned through good - and bad - examples, ways to handle crises. We're not islands. One day we will all be there facing our own mortality and/or the serious illness of a close loved one. Why wait until then to learn what is important to you?
If you have not already done so, it is important to ponder your own wishes regarding your life - and death. Talk to someone you trust about what values and beliefs are important to you, and your health care wishes. Make an Advanced Medical Directive. Designate a medical power of attorney. Spend time with your loved ones. With those family members who you don't get along with - make amends where appropriate - or set limits when this is the best strategy. You can't be close to everyone!
I am glad that my life led to this point, and am grateful to work with a team who truly care about their work.
RMH Palliative Care, now in its third year, has expanded from an inpatient consult service to an outpatient clinic. Our hospice program, now in its 30th year of service - continues to provide quality, compassionate care for people in their own homes, private homes, in assisted living facilities, and in our area nursing facilities.
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