On National Doctor’s Day, reflecting on the privilege to serve…

Posted by Judith Nerad, MD

On National Doctor’s Day, reflecting on the privilege to serve…

I am often mindful of the quote by Albert Einstein, “I have no special talents, I am only passionately curious.” I feel that there is a driving force inside of me to help others, to relieve suffering, not as a noble endeavor to call attention to myself, but because I have been given so much. I want to use my talents and opportunities to help relieve the burdens of others. This is what I strive to do.

What is a memorable patient story for me? My husband’s dear friend of many years was diagnosed with a rapidly progressing form of ALS at age 62. He and his wife were part of a group of friends who had stayed in touch for many years, through many changes. His daughters were my children’s babysitters. 

We saw him a few times socially during his illness, and his spirit, bright smile, and sense of humor was always there.

As he got sicker, we saw him less. He became a JourneyCare palliative care patient and eventually a hospice patient, well cared for at home by one of our home teams. As he declined, he did not want company so much because of difficulty communicating, thus I had not seen him for a few months.

He eventually was transferred to one of our inpatient units. I went to visit him. He was surrounded by his wife and a few family members. His wife was talking to me, telling me about his journey. She suddenly noticed that he had taken his last breath! We all stared at him, they looking to me to confirm that, yes, it was his last breath. 

Incredible as it may seem, I have not been in the room with a patient when they have taken their last breath, not before nor since. For me to have been so peripherally involved in his direct care, and to have visited him at that moment in time, and for him to decide to take his last breath then, I am in awe. There are reasons why things happen the way they do, and we do not always come to know them. 

I find it hard to write about something I did as a doctor that impacts a life. In the hospice model, we all work together as a team to relieve pain and suffering in our patients. Whether the pain is physical, emotional or spiritual, we all try to lighten the burden for our patients and each other.

Since changing to the field of hospice and palliative care, I have learned so many things about medicine, about life, about myself. I am grateful for the opportunity to work in this field and the privilege to be welcomed into the lives of our patients at such an intimate time in their lives. I am amazed at how much healing takes place within families during the final days and weeks in a patient’s life. I am in awe that I can be a witness to that. 

I am in awe of the CNAs (certified nursing assistants) who see our patients every week, when they are in their most vulnerable and compromised condition. The CNAs are present, respectfully, bathing, cleaning, talking, calming our patients in everyday conversation, to put them at ease, helping them accept their loss of control of their lives. Their regular, consistent gentleness and respect bring great comfort to our patients.

I am in awe of the chaplains, from myriad faiths, who meet the patient where he or she is at spiritually, without judgment or dogma. And each week in our interdisciplinary team meetings, our teams hear an inspiring message from our chaplains, grounding us in the spirit of what we do.

I am in awe of the social workers who have tremendous skills in counseling and listening to our patients, our colleagues, each other. They bring creative solutions to issues or problems our families confront. They are tireless is looking for resources and opportunities to help patients and families meet their goals. They bring great comfort to families who do not know where to turn.

I am in awe of the nurse case managers who day in and day out meet with the patients, take the time to educate them and their families, comfort them in their insecurities, their fears. They help them meet their changing physical and emotional needs. They see the big picture of the family dynamic and are flexible and creative to move the situation forward for the best interest of the patient.

I am in awe of the multiple services JourneyCare provides to our patients and their families. The support we have from volunteers, team managers and specialized therapists fill in many gaps in patient care that ease their burdens. The administrative clinical staff and infrastructure staff provide a solid foundation allowing us to do the clinical work that is so meaningful to our patients.

Each week when we review our deaths, I listen to my coworkers who have been with patients on a daily to weekly basis and have seen the decline in their clinical status, have seen them die. I wonder how they can keep doing this work each day. I am grateful for them and their commitment, dedication, perseverance, compassion, and love for what they day do. 

I am grateful to be a part of this work. It is my privilege to work in this field. It has helped me to be a better physician, a better friend. 

I would like to end with a quote by Mother Teresa (provided to me by my friend and colleague, Dr. Usha Mehta):

“There are no great things, only small things with great love. Happy are those.”

To learn more about hospice care, visit journeycare.org.

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