Reflections on Palliative Care: Clinging to Life

By Dr. Allison Schneider

My first day on the Palliative Care service ended with me in a heap on my couch sobbing into my husband’s shoulder. That day I attended family meetings for two patients in their 40s dying of cancer and leaving young kids behind. I also sat at the bedside with the mother of a young man dying of AIDS. As a fourth year medical student, I had experienced hard days; that day was one of the hardest.

Yet, it was also beautiful. The interdisciplinary palliative care team navigated each conversation with inspiring empathy and grace. They worked together seamlessly to support and honor the goals of each patient and their families. The team also made it a priority to support each other. Through frequent check-ins, debriefs and formal talks about self-care, the rotation created a truly safe space to express and work through the raw emotion that end-of-life care can trigger.

It was after that day that I turned to writing as a way to both process and remember these patients and the intimate moments we shared. I started by jotting down words or phrases from conversations that kept replaying in my head. I call them poems (though I’m not a poet), but in truth, they are remembrances. They are my small way of paying tribute to the patients who moved me, who let me learn from them, and who allowed me to be present with them and their loved ones in some of their final moments.

 

Clinging to life

He has so many people who love him.
They’re all talking about him.
75,000 people and counting,
on his Facebook page, you know?
Isn’t that amazing?
He’s done with his body.
It’s just a vessel.
And he’s comfortable now.

Drip, drip, drip.
The twitching starts.
His body hovers between the present and past.
Gaunt.
Wasted.
With a splash of color on his bed – he loves color.
The sunflowers, once bright yellow
now rest brown and wilted in their purple plastic vase.
But the vessel hangs on.

Just mother, brother, and son.
Shhh, it’s okay to let go.
You’re safe.
Go now.

 

Mr. S, age 43, HIV/AIDS

 

Pronouncement 

They sat by his bed for days.
Gathered together.
Calm, quiet. Stoic even.
Waiting.
Accepting.
But, as we entered the room,
and carefully confirmed his final moment,
the silence broke,
giving way to wails and tears.
Love and grief
unleashed.

 

Mr. H, metastatic colon cancer, age 80

 

Dr. Allison Schneider grew up in Washington, D.C., and received a BA in Public Policy and American Institutions from Brown University. She then worked for the Kaiser Family Foundation Commission on Medicaid and the Uninsured prior to entering medical school at the University of California, San Francisco. She graduated this month and will be starting her residency training in Obstetrics and Gynecology at Kaiser Oakland Medical Center in July.

1 Comment

  1. Rosemary Guptill on May 27, 2016 at 4:44 pm

    My mother who died at 63 from cancer told me “my dear life is not fair, but concentrate on the ups and not the downs”. It is not easy to do but I think you understand. All good thoughts to you and yours. God give you strength to be there for those living the “downs”.

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