Ask most people how they'd like to pass on and they'll tell you they want no pain and suffering. As a physician hospitalist, I believe I have an obligation to provide the patient with all treatment options, including the option of palliative care. Despite the misunderstandings of many patients, families and physicians, a palliative care program can often increase the quality and quantity of life while allowing a natural death with dignity. These are not death squads. They are dignity squads.
As a hospitalist, I rarely get to experience the after math of a palliative care or hospice discharge. Most folks will pass away as expected. Some will surprise us and out live their prognosis. Some will change their minds and experience a miserable death filled with great physical and emotional trauma in their final days. For those that survive the emotional transition to a palliative care program, life can give them some of the best days, weeks or months they've had in a long time. The other day I got to experience the joy of a stranger. I'd never met the lady. She knew me immediately. In fact, she came right up and shook my hand in the middle of a hardware store.
Doctor Happy? I knew that was you. It's been five years since you took care of my mom. I have always wanted to come up and give you a hug.
Of course, after five years (or even five weeks), I can't possibly be expected to remember all my patients, let alone their family. She explained to me how I recommended hospice for her mother during a hospital stay. After a long battle with emphysema, spending more time in a hospital than in her nursing home, her mother entered into hospice at discharge.
She lived for three more weeks. Some of the best weeks she'd had in years. Gone were the thirty-five pills that left no room for food. Gone was the dysphagia three diet. Gone were the limited pain meds from agonizing osteoarthritis. She got what ever she wanted. She even got a steak. And she loved it. The day she died, everything seemed normal. Nothing out of the ordinary. Except she got a call from mom who said she had seen her husband that morning. Her husband had died eight years prior. Later that night, mom died peacefully in her sleep. How amazing is that? Makes you wonder if palliative care is a gift from God we should all embrace when our time has come.
