Summer Elective : A week living with the dying.

Assalamualaikum wbt.

(idk why I started to feel awkward to start my post with this. Maybe because I don't think anyone will read the stuff I wrote here. Oh well.. )


Anyway.
Last week (from the 23rd July - 27th July) I did my summer elective at one of the best hospice in Ireland. Emm I'm not sure if the word 'best' is appropriate to describe a hospice though. So a hospice is basically a hospital that caters to end-of life care.

I started the week feeling so pumped up with adrenaline, I have prepared myself to witness the thing I feared most in medical field - watching your patient die!

So I walked into Marymount Hospice in Curraheen with that mindset - I want to be stronger emotionally. I want to be prepared. I want to learn how not to get affected by loss(es). The reason I choose palliative care for my elective is mostly what I said above .. and a tiny bit of  I-havent-had-this-kind-of-exposure-in-fourth-year and also a little bit of this-one-week-elective-gonna-fly-without-much-learning-to-do.

I started the week with MDT (multi disciplinary team) meeting , there I met my supervisor (Dr Marie Murphy), the Reg and SHO (Ciara and Dierdre) , the staff nurse ( I call her V) , the pastor (Daniel) and the community staff nurse (Mary) and the ward manager (Ger) . They were soooo nice and welcoming. I feel great.. but halfway through the meeting, my sleepiness from jetlag started to kick in. I cant believe I dozed off for a few secs, i hope no one notice that!

So the week went by with MDT, ward rounds, coffe breaks, more ward rounds, taking history and do examination on stable patients, listening to doc's prognosis on some of them was hard, but that's part and parcel of the job. 

I started to feel like : this is such a bad place to work in. Some of the patients I see during ward rounds are feeling low -almost all the time. Prolly because they are lonely and thinking of the ones they will leave soon. 

I asked my supervisor one fine morning "The patients are feeling low, you can't cure their disease / illness. Why palliative care though? What drives you to continue?"

So Dr Marie Murphy gave me the best answer anyone could, she ask me back. What's the principles of providing healthcare? 

And I was stunned. All I know is "DO NO HARM" lol. 

She added "..Do no harm, do good to patient, respect their autonomy, and respect the use of your resources"

So she explained on how we must care for the patient as an individual, striving to ease their pain, giving them chances to live in comfort and pain-free, improving their quality of life for no matter how many days/weeks they have left. 

Those things.. matters to the patient..maybe more than just having the chance to live an extended period of time but constantly in pain, unable to eat, and feeling weak all the time.  What's the good in that?

and she corrected me : "and you know what, not all of our patient here died in this facility. Some of them gets better than how they presented at first. We treated their symptoms and we are happy, as much as they are happy to go back home and spend their time with their family. That .. to me, is a good motivation"

This place might not be as big as Cork Uni Hospital, with hundreds of beds. But I like the ambience here, I love the lessons I learn - as a doctor, you do not treat your patient's symptoms like crossing off  things from your list. Treating an individual is more than that. To make them feel human again. To make their life worth living. 

As I walk down the stairs for one last time, I thought to myself. If I can't treat hundreds of patients each day, having one that genuinely feel good after our encounter is all I need as motivation and drive to continue. 

This job is never a fulfilling one if what you seek is popularity and good money. I hope I can keep my intention pure in providing what's best for my patient, using my resources as ethically as I can and respecting them as human beings .. and not just another case to settle before I go back and hit the bed.

And I think.. it is okay to have soft and mushy heart that breaks 

every time I experience loss(es), witnessing death 

and other bad news that I have to deliver to my patient 

as I see their expressions become gloomier. 

It is okay to feel bad, to shed tears. 

It is part of our human emotions.

Let's not lose the empathy every single one of us should have.

With that in mind - I hope I can grow to become a good doctor. 

One that can give my best in any given situation. InshaAllah. 

"Rabbanaa laa tuzigh quloobanaa ba’da ith hadaytanaa 

wahab lanaa min ladunka rahmatan innaka antal-wahhaab"

“Our Lord, let not our hearts deviate (from the truth) after You have guided us

and grant us mercy from Yourself . Indeed, You are the Bestower.”

On my last day, I saw this on the reception desk. I can't help but to capture it. :)