Right as I was about to enter the room, I hear a loud "F***! F***! F***!" The tone of voice is brittle, harsh. There's a tinge of desperation in his curse words. There's a dripping quality of haggard futility in how he pronounces his "-uck." The "F", the "phhh" sound is too soft for his urgency in pain, so he lashes his tongue on the "-uck." Uck. Period. Uck. Period. Uck. Exclamation. Curse words whipped at the white wall and the prison of his body. I pause and knock three times. There's a silence in his lashing and I enter his domain. As a volunteer, I proceed to listen to him curse at me, the wall, himself for a good 5 to 10 minutes. He subsides. The onslaught is over and he turns his body away, willing me to leave. Welcome to my introduction to palliative care. It has a penchant for the dramatic doesn't it? It's hard to explain what it is you are participating in without going amateurish literary in your descriptions. There are portions of urgency, sentiment, a good story behind the cursing, and yes, the terminal illness. The great equalizer of death. Whereas life remains unequal and inequitable. We are often taught on how to "assess" for palliative and we discuss various nuances of legal ethics on the "right to die," or euthanasia. Theoretical ethics is great in defining the legal actions of being a doctor, but it's also a great way to distance yourself from the very difficult quality of active dying. And the flip-side of distancing, is to listen. The quality to listen - whether it's your "calgary-cambridge" framework or "motivational interviewing" is the same. It's an active participation on "giving a damn" to know the other human being in front of you. And it's hard! And often times, that's why physician burnout is so detrimental - cause we can no longer put in that maximum effort. We have to train the muscles of our "soft skills". Now, this isn't some preaching to be all "sentimental" since, we often confuse niceness, sentimentality, and kindness to "soft-skills" (The cliches are true though: We see, but don't witness. We hear, but don't listen. We speak, but don't connect). But, with palliative, it's a direct question on the reality that faces physicians on what is death and what is the urgency of death. And, in contrast to all that we learn to fix, resolve, maintain - how we remain often, merely holders of that very precious "human inadequacy." I won't write a long piece on the intricacies of end-of-life or palliative here. However, there are many good articles on palliative care and end-of-life and it's worthwhile to have a read on what will be a reality to all of us. There are some books written by both Atul Gawade and Christopher Hitchens on this tricky issue of mortality. My personal favourite however is Anatole Broyard's essays called "Intoxicated by My Illness." Grab a hold of it if you can. On a theoretical note, it's also worth looking past the legalistic side of "right to die" that is accompanied by our growing human rights discourse. There's an alternative side that many don't read or know about that includes our societal shift to "letting live." Oh, and as for the individual above. We had a nice long chat afterwards and he became quite popular with the nurses! I believe they called him a "sweetheart." Oh we, simple creatures of complexity! Sang Ik Song is a second year medical student at UL GEMs.
20 Comments
|
CaesuraRotating views on various subjects concerning health (in)equity Health Equity NutSome streams of consciousness on the subjects of the tragic and the mundane. Archives
February 2021
Categories |