This is how one physician thinks about her patients' acceptance of death.
Death is never neat. A good death should be defined by how well and honestly we care for the dying, not by their performance on our behalf. |
 | | Joshua Bright |
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It's been almost a decade since I finished my medical residency and became a "real doctor." After training ended, I faced one final hurdle: passing a grueling eight-hour-long internal medicine board exam. Back then, it seemed as though there was nothing more important than knowing the right answers. What I didn't know was that when practicing palliative care, it's really about asking the right questions. |
As a resident, I would have never let myself consider only the most obvious diagnosis for a patient's illness. But when it came to my patients' personal lives, I too easily assumed the simplest narratives: Amid a health crisis, previously divided families would surely rally around their loved one. A person dying at the age of 90 must have lived a long and fulfilling life. Agreeing to hospice care meant that a patient had accepted that they were dying. |
Back then, I didn't question what "accepting" death really meant, or whether it was something I could expect from my patients. I struggled to ask about their suffering unless they seemed ready to embrace their fate, fearful that I might inadvertently worsen it. But as I write in my guest essay this week, I've learned that awaiting specific imaginings of acceptance only justified avoiding having necessary conversations with patients and loved ones about what they fear and need as death nears. |
Several days ago, I sat in the corner of a hospital room with the daughter of a patient suffering from incurable cancer. She was a nurse, and told me that she was worried that her mother hadn't come to terms with the end of her life. I know the stages of grief, she said, and I think she is in denial, but maybe you could help her understand she needs to accept what is coming. |
Ten years ago, I would have nodded, confident that I might help her mother, earnest in my naïveté. I still feel the initial rush of my inclination toward rescue. I knew the answer she wanted, but instead I asked a question. "I'm happy to speak with your mother and understand how she is making sense of what she is going through. But is this conversation also a way to help you to find peace?" |
She considered my question. Then she met my gaze, her eyes brimming with emotion, whispering, only, "Yes." |
| READ SUNITA'S FULL ESSAY HERE | | |
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