The Privilege of Being There…
By Mickey Ryan, CRNP –
After starting my job in the IPU, I would read the obituaries of patients I had cared for, and feel guilty about not having known more about who they had been, their accomplishments, etc, when they were well, or at least less severely ill. But the more I thought about it, the more I realized I couldn’t possibly know this about all the IPU patients, and it’s OK.
When my father was diagnosed with cancer, I told him that he was still him, not a disease. Of course, I did know him when he was well. But even so, as the cancer progressed, he became less and less like himself, no matter how much I wished it wasn’t happening.
So I’ve accepted that my place in our patients’ lives is at this time, when their disease process is obliterating their ability to be who they had been; when they’re having trouble breathing, or are overtaken by pain and debility, when they no longer want to eat, or have withdrawn from everyone and everything they ever knew; when they no longer even slightly resemble their former selves. I am a witness to the transition from their life-long experience of reality to whatever lies ahead. My job in this time is to help their journey be as smooth as possible, to minimize their suffering, as they step through a door which is currently closed to me but will some day be open, and to help their loved ones see and value the experience, rather than running from it. So I listen to the stories, admire the family photos, but focus on how their dying process is going. And I rarely read the obituaries.
As my husband said so comfortingly when we went to the funeral of a 5 year old child who died in my IPU after being here for 7 days, and I told him with some regret and bewilderment that I only knew the child for a week, yet felt so connected: “Yes”, he said, “but it was probably the most important week of his life.”
The takeaway messages for me are:
- I can only be in people’s lives when the opportunity presents itself, but I can always strive to be someone they’re glad to have met. This applies to every day life – not just hospice!
- Dying is not cold hands & feet, mottling, delirium, cachexia, agonal respirations, pain, anxiety, or regret. It is a phase, a turning point, a threshold, and the inevitable result of having been given the gift of life.