There are two things that are certain in life. Death and life. We prepare for birth for the most part but so often we ignore death, run away from it as though it will never catch up. Death is inevitable and so I think it is vital that we embrace it insomuch as we talk asbout it, prepare for it. Even among Christians who should know that there is life after death and for them at least, eternal life, there is still this fear of death. Fear to the point that we rebuke, blame it on the devil etc. I am not ignorant of the emotional effect of losing a loved one or someone dear to you but I think we can ease the blow of death by facing it head on and preparing as such..
I had this patient who was quite elderly, the first day I was on service I knew that we needed to talk about hospice and code status. I met with her MPOAs and questioned them about what they knew about her condition. As it is in most situations, they had some very unrealistic expectations. They did acknowledge however that she did not want any heroic measures and actually wanted to be a do not resuscitate or DNR. As the day continued, I put a bit of pressure on the MPOAs to follow their loved ones wishes.They finally decided to move her to hospice. The next day, I realized that she may not make it to hospice before she left this earth. Sure enough, I got a call from the staff that she was actively dying. I went to the bedside. Called the family. They never came. But we never left her side. Myself and the staff stayed at her bedside, holding her hands,rubbing her feet and me singing to her as she gracefully left. It was such a beautiful special moment, we cried but rejoiced because this lady had lived a full life.
I have asked myself many times why physicians shy away from talking about death and dying? We know the science, we understand the anatomy,maybe it is the spirituality that we are afraid of? I am not sure but I think that we need to get in the business of preparing our patients for life’s inevitable. The times that I have taken to educate my families about death and dying has been time well spent because they were able to appropriate their time with their loved ones. Let’s take the step to have the conversation.