September 2024
Holy Water
My father-in-law was dying. He’d had five years of remission from esophageal cancer, but the latest recurrence hadn’t responded to treatment. As he neared the end, he and his family decided to move him from the custom-built contemporary home he’d designed to a privately run hospice, just over a mile from his home.
I had taken some time away from work to support my husband, his father, and the family during those last days. My main jobs were to run support and errands as needed so the family could stay at his bedside.
Listening
It was an overcast Saturday as I made my way down the hall, examining one elderly patient after another at our in-patient hospice unit. Mr. G was alone, his room dark. He didn’t respond to my voice. I wasn’t surprised: his nurse had told me he was close to death and appeared comfortable.
I reached for his wrist to feel his pulse with one hand while I placed my stethoscope at the bottom of his sternum. No radial pulse. But the sound of his heart was remarkable: a thrumming, a quivering, a vibration, a sound I’d never heard before but instinctively recognized. He was in ventricular fibrillation, his heart was flailing.
“Hey, Uce”
I’ll never forget my shadowing experience in the emergency department during my first year of medical school.
Scanning that morning’s list of patients, I saw a last name that made me do a double-take. A distinctly Samoan name: Mr. Fuaga.
My father’s side of the family came to the States from Samoa before I was born, and I grew up curious about Polynesian culture. My father always taught me to seek out fellow Pacific Islanders in whatever path I pursued, no matter how few of us there might be.
Neighbor
I first notice the fog, unexpected
on the inside of a windshield,
a question mark
along the run-on sentence of parked cars, and,
with a snap, you are there,
wrapped in a bag in the back
seat with parking patrol on the prowl,
but they’re not so keen, blindly
driving by in a kind ignorance,
and I don’t see you either,
only your warm breath
caught at the glass,
and all I have are commas,
Where Mortals Suffer Life
When she came, her legs were cold and her heart weak. The tracings showed flickering beats. She was confused and barely there. She was a ticking time bomb.
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Feeding Tubes – To Place or Not to Place?
Sometimes I have to pinch myself. Is this really my twenty-fifth year of practice as a palliative care physician? My head is full of memories of caring for hundreds of patients as they navigate their final days of life.
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Kindness in the Face of Loss
Editor’s Note: This piece was awarded an honorable mention in the Pulse writing contest, “On Being Different.”
I’ve just received a call from a hospital: An urgent appointment at its fetal-medicine unit has been arranged for me for tomorrow.
I try to get all the critical information.
“Which hospital did you say?” I ask. The medical secretary repeats the name, sounding a little surprised. I haven’t heard of this hospital; but then, I haven’t really heard of any, except for our local one.
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Hospice Angels
I would not have survived caring for my parents at the end of their lives without the help of my hospice angels. Ma spent the final 10 days of her life in a palliative care facility; Dad endured the last three months of his life getting at-home hospice care. The individuals from hospice—nurses, occupational and physical therapists, counselors, and aides—not only supported my parents but also gave me the love and care I desperately needed.
September More Voices: Palliative and Hospice Care
Dear readers,
My thoughts and feelings about palliative and hospice care took hold during medical school and residency training.
I was a medical student during the AIDS epidemic of the mid-1980s, when our Bronx hospital admitted a succession of patients infected with HIV, a virus that compromised their immune systems and made them vulnerable to a host of infections.
They came to the emergency room short of breath, feverish, somnolent, unable to see properly, convulsing, soiling themselves with intractable diarrhea…The list of possibilities was long and scary.
These patients, invariably young, were all going to die.
September More Voices: Palliative and Hospice Care Read More »