Check In #1: My First Rotation in Palliative Care
A lot of people do not understand the field of palliative care and hospice. I definitely didn’t when I started this rotation two weeks ago. I can truly say that God was so gracious to me by allowing me to start this year of clinical rotations with this. From a staff that closed check-ins with prayer to the amount of time we had to actually sit and spend time with our patients, it was a great way to ease into things.
To start, I want to explain what I have learned palliative care is and why it is so necessary. First, palliative care is about helping people with terminal illnesses to live out their remaining days as enjoyably as possible. The last day is when you die, but the overall focus is not on death. The health care team works hard to alleviate any pain or discomfort a patient has while helping their family to cope and prepare for the rough time to come. The priority is no longer fighting to find a diagnosis and treatment to a medical dilemma. The priority is the patient and their wants and needs.
In this country, there is a pervasive belief that death can be avoided. Some people want to do every imaginable intervention for illness with the worst prognosis because they do not want to accept the fact that death is inevitable. I am no stranger to death and dying, but my viewpoint on it is different from that of people in this country. When someone gets sick in Nigeria, if they have family with the means, they get out of the country to receive medical care. When my grandfather was diagnosed with cancer, my parents brought him to the US to get treatment. However, when the doctor told us that the prognosis was bad, everyone accepted it. I remember being at his bedside when they gave us the news. Sadness enveloped all of us, but we accepted it and tried to enjoy the time we had. We had nurses come and visit our house to do the tasks that we couldn’t, but when my grandfather felt his time was near, he asked my dad to take him home. My dad took him home to Nigeria two days later. He died three hours of making it into his own bed, at peace because he got to live his last days his way.
I had the privilege to spend time with several patients who were at different stages of dying. I say privilege because it is a privilege to be training to be a physician in the first place. Physicians offer two things: their presence and their provision. Provision is that solution oriented part of our job, but our presence is honestly worth so much more (when you’re not one of those typical pretentious physicians). In addition to learning the types of drugs most used for symptom management and learning how to explain what to expect throughout the “death process”, I was able to sit and hold someone’s hand, help someone take a sip of a cold Pepsi when that was all they wanted, cheer up loved ones with my crazy life stories, share a devotional I read with a patient, and offer healing and comfort in a unique way. I saw a woman go through the first few days of her dying process. The first day she was lucid and could have light conversations. I remember her husband (of 57 years!!!) say “Oh ya, that’s my gal.” I died inside. (poor word choice but that’s what came to mind and I try to keep it real okay!). I visited them every day. On my last day, the wife was no longer speaking, but I watched the husband sit by her side, rubbing her arm while playing some old gospel tunes on his little ipod. I sat with them for a little while before telling them that this was my last day. I told them that they had taught me so much and how much I loved watching their love. The husband was so joyful. He said how great the facility was, and how all the doctors really cared about his wife and her wishes. He said he was so happy to have her here, peaceful, even though it was so hard for him. And then he thanked me for coming by and wished me well. The tears that came. Man. Love is beautiful.
This was a side of medicine that I have never seen. No. I don’t think Palliative Care is the specialty for me as of right now, but I am so grateful for the experience I had and for those doctors who have been called to this much-needed specialty.