A few months ago, I was asked to give a talk answering the question, “What is your hope for healthcare?” Here is the transcript and an embedded audio version of that talk.
My hope for healthcare? That we stop viewing death as our failure, and start considering it our opportunity.
In Bhutan, there’s a belief that thinking about death five times a day will make you happy. In Thailand, Buddhist Monks have been known to meditate to photos of rotting corpses as a reminder of their own mortality.
Pretty dark and twisty, right?
But what if thinking about death is the dark and twisty secret to living a more fulfilled life?
As a palliative care doctor, I think about death and dying every single day. And I’ve come to appreciate the benefits of having a healthy relationship with our mortality.
I’ve also seen the overwhelming discomfort with which healthcare providers receive death into their practice.
When I come to see patients who are near end of life, it’s not uncommon for me to hear members of their healthcare team say things like:
“We’ve run out of options.”
Or
“There’s nothing more we can do.”
They shroud the dying with euphemism. “The patient is palliative,” they say. Confusing the attempt to alleviate suffering with dying itself.
The issue with these phrases, is that they apply a very medical lens to the very human experience of dying.
By saying things like, “There’s nothing more we can do,” we imply that when medicine can no longer cure a disease, we as medical professionals have nothing left to offer a dying person.
It’s this narrative that drives our collective death anxiety in healthcare, equating the death of a patient with a failure of our practice. This can create an uncomfortable space for those of us who choose to work in healthcare because we want to help people… because we want to save people.
So it’s not surprising that we sometimes turn our backs to our dying patients.
If we apply a more humanistic approach to the issue of dying, we quickly learn that there is always something more we can offer, even to a person who has limited time.
We learn that saving deaths can be as worthy a pursuit as saving lives.
The cornerstone of the work we do in palliative care is medical management of serious, life-limiting illness, along with meticulous pain and symptom control. But the magic of our work happens when we move beyond the medical particulars and consider the human face of dying.
When we have the courage to look our dying patients in the eyes, and consider their struggle as something we too will one day face, we realize that there is hope beyond cure. That there is always something more that can be done.
Perhaps it’s giving a manicure to a woman as she takes her final breaths, after she fretted a day earlier about her chipped nail polish. Or maybe getting a lobster dinner for a homeless man receiving medical assistance in dying the next morning, a final request for a small luxury, coming from a man who ate in shelters for much of his adult life.
Maybe it’s helping a frail but feisty bed bound elderly woman get outside for the first time in weeks, so she could enjoy a cigarette and gin and tonic, as was her ritual every night before she got sick. Or even holding space for someone in the early moments of death, honouring them as a whole person who loved, and was loved.
What we don’t learn in medical school or nursing school is that we have the power to heal even when we can’t cure.
In sharing these and other intimate moments with my patients, I have been changed. In a way, I too have been healed.
So, my hope for healthcare? That we stop viewing death as our failure, and start considering it as our opportunity.
Our opportunity to see our patients as vibrant, whole people, with priorities in their lives beyond just living longer. Our opportunity to see the humanity in our patients and in ourselves, for there is no experience more universally human than the experience of dying. When we take advantage of these opportunities in the face of death, not only do our patients benefit, but so do we.
Caring for people who can’t be cured can teach us incredibly valuable lessons.
Lessons in humility – That nature will always prove more powerful than even our strongest medicine.
Lessons in compassion – that when we are faced with an unfixable problem, sometimes the best thing we can do is sit in solidarity with our patients’ uncertainty and lean into their suffering, rather than turn away from it.
Lessons in human connection – that death truly is the common ground of humanity.
In being present with our patients who are dying, we may start to consider our own lives a little more thoughtfully.
We may even learn to embrace our inevitable mortality, perhaps finding ourselves inspired to delight in life’s simple pleasures. Like a fresh manicure in fire engine red, or the rich taste of lobster dipped in warm melted butter, or the crisp familiar bite of a gin and tonic.
The death of a patient is not our failure. Our failure is what happens when we turn away from the people who need us most.
So the next time you think “there’s nothing more we can do”… remember your power to heal even when you can’t cure. You may even find yourself being healed along the way.
Until next time,
Lauren
P.S. One day you will die.