Long Hours, Luck, and a Cast of Thousands

Abstract

On the third day of the vigil for my Mom, I walked in to see my 19-year-old niece sleeping in a chair next to her grandmother with my black lab, Moki, sleeping under the bed (Fig. 1). Moki, an enthusiastic 7-month-old puppy, regularly visited my Mom, usually bounding into her room and licking my Mom’s hand. For four days, he slept under my mother’s bed. This scene of my niece and my dog sleeping at the bedside of my dying mother was the gift of hospice. With assiduous use of medications, my Mom was no longer seizing, her breathing was comfortable, and she appeared peaceful. This gift allowed us as a family to be at her bedside and focus on saying good-bye as opposed to the terror of watching her in pain or with another distressing symptom. Four days after my Mom’s funeral, I took (and passed) the ABIM Hospice and Palliative Medicine Certification. Growing up in rural Pennsylvania, I would have never imagined that one of my proudest statements that I make on a daily basis is: I am a physician who is privileged to work for hospice. The majority of teachers and family would have never predicted my success, let alone that part of my job would be based on my ability to write. My brain is definitely not wired right. For many years, I signed every note to my now 20-year-old niece, ‘‘Love, Anut Joan.’’ I probably wrote that a thousand times not picking up on the obvious misspelling until my older sister told me, ‘‘You are a NUT, but I want you to be an aunt to my child.’’ We are all given our own crosses to bear. Through perseverance, long hours, lots of luck, and a cast of thousands, I have been fortunate to make a small contribution to the emerging field of palliative medicine. Here are a few lessons that I have learned along the way: