I am not proud of it, but I'm not really embarrassed by it either. I don't want to do it ever again either.
We have a patient in hospice who is in her twenties. She has EXTENSIVE adenocarcinoma, that she ignored while she was caring for her ailing mother. She knew she shouldn't have been bleeding like she was or having the massive discharge that she was experiencing but rather than address it, she ignored the existence of any problem. A year later her mom forced her see a doctor but by that time it was way too late for any kind of treatment. She has a massive wound and an even more massive tumor burden, has been in hospice for over a month now and has been stable and in no acute distress. She participates in activities to the extent someone who is bedridden can. She is usually outwordly cheerful and upbeat, if not denying any problem really exists. Since late last week she has been getting worse (bleeding, tumor growth) and today we informed her that she may not have long to live. It was the first time I saw her openly grieve her own loss and perhaps accept that she would soon die. We left the patient to cry alone, as she requested, and a couple minutes after I left her room I began to cry. Not sobbing or whimpering, just quietly letting tears stream from my eyes. The PA followed and we sat down together to discuss my feelings and how this young lady's imminent death had effected me. It had touched me so much because she is so young and I know that there are so many things she has missed out on and will never get to experience. Too, I felt that I had whitnessed her accepting her death. Literally accepting the fact that she would not only never get better, but that she would soon no longer be on this planet. So we talked and I let a few more tears fly and blew my nose a couple times. The PA gave me some words of comfort and advice and we got up and went to see the next person not long for this world.
5 comments:
Wow, that must have been rough to see. Sounds like the PA handled it in a remarkably supportive way.
Did you ask the PA how (s)he deals with such feelings after a few years of experience? If so, did it help much, or is it just something that time will help you deal with?
I am also curious as to the advice the PA gave you. If you wouldn't mind sharing, I would greatly appreciate it.
You know there aren't any great tricks or extremely sage advice. Earlier someone on the team gave us an example of the differences between empathy, sympathy and compassion. The gist is that one should strive for compassion. For example seeing someone drown in a raging torrent, you don't dive in after them to drown as well nor do you throw them a lifeline and hold on until you too are dragged in, but rather throw them a lifeline and tie it to a tree and step back. The idea is to help without being harmed. The PA and others strive for this sense of helping by not being dragged down into the fire with the patient. The PA also suggested the ol' think of baseball routine. You know fellas, when you are being intimate and the 'time' is near some of think of baseball or all the chores we need to do - something to allow us to remain in the moment while not being overtaken by it. Same sort of idea, that you somehow place a barrier between you and the patient that allows you to be present and cognizant, but not entirely engrossed in and overcome by the situation. The doc says he alternates tapping his big toes in his shoes during times when there is an emotional onslaught from the patient, whether it be sorrow, anger or frustration. It allows the brain to be distracted. The idea is that we can't really save these people from their feelings but by the nature of the job we must be there for them during these difficult times, if only to be the person on whom their emotions are spewed and dumped.
Hey P, just came across your blog. Wow. Very sad for her and her family. I probably would've reacted the same way. ...
By the way, hope school is going well. You and I have much in common. First, I am 39, engaged, looking to have kids soon and completely changing careers- Possibly to Physician Assistant. I'm an outdoor nut from Hawaii who also lived in Texas. Anyhoo, Is there a way to contact you and ask you some questions about the training? This career looks awesome. Email is fine too. I'm at Kaleogriffith@yahoo.com
Aloha, & I wish you and your family much happiness. Kaleo
Very moving post. I so appreciate your sharing your experiences. I can see why everyone on a hospice team would work so well together--it must take a certain kind of person to be able to help someone through the process of dying, and all that implies.
You are making me really want to go for it--becoming a PA--despite the fact that I'd be 62 upon graduation. Suppose they hire 62-y.o. newly minted PAs?!
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