The following piece was written by Maggie O’Connor, MD, a lead physician at Abbott Northwestern Palliative Care Team. Dr. O’Connor is retiring on August 5th, and as part of her departure she decided to share some words that touched many in the medical community. I found the piece so moving that I asked if I could share it on my blog. Below is what she wrote in a weekly newsletter to staff and colleagues.
I have written at least five draft versions of this and finally settled on three things I want to say:
- Dying is not giving up, quitting or a failure.
- We are the medicine.
- Thank you.
A few weeks ago I said goodbye to a man I had known for a couple of months who I knew would either die or be discharged to a residential hospice before I could see him again. Diagnosed with cancer this spring, he had gone through a grueling course of chemo and radiation in hopes of shrinking his cancer, having surgery and being cured. A few days before I saw him in the hospital, he had learned that the cancer had spread and he was dying. He came into the hospital frighteningly short of breath. During my first visit, he said he couldn’t bear to go on living. He felt like he was only a burden on his family and of no value to anyone.
I gave him meds to ease his breathing, and we talked about the number of people I see who share his feeling of wanting to get dying over with, but often this is because they either feel so bad physically or have no sense of meaning or purpose. And yet, when they realize there are things they still want to say to their family or share with them, they feel that sense of purpose returning.
His eyes lit up. I knew he got it, and I left him with that. Over the next few days, his shortness of breath eased. My visits were not long. He was busy talking with family, passing on his wisdom. Sometimes I offered thoughts on the choices he was considering, but mostly I just popped in every day as he did his work preparing his family. He could barely get out of bed, but his manner was filled with grace and dignity. Dying is as heroic as battling the disease.
We are the medicine.
All the tests we know about, procedures we can do, diagnoses we make, physical care we provide and collaborative team-working we have are important and are part of what I love here at Abbott Northwestern. But there is another part of what we do that I see every day, even in the rush and distraction. I have seen it in the transport person who appeared to step back a little and wait without a care as an elderly woman—who didn’t want help, mind you—slowly walked up to the cart and stepped up on the stool that he provided. Once she was on board, he adjusted the covers and settled her in. Or the rapid response nurse who paused before launching into the protocol to ask the patient and family about their hopes and goals for treatment, which happened to be just beginning to shift toward comfort. Or the doctor who, when I asked him what he saw ahead for a patient I was meeting, told me, “Nothing but tears.”
Whether we are racing or going easy, whether we can spend time or have only two minutes, whether our hearts are light or weighted down, the attention we give to the patient in the moment makes a mighty difference. The look in the eye, the anticipation of a need, the belief that we can help the situation – that presence is healing. We are the medicine.
So, time to say goodbye. Thank you for the jokes—good and bad, the camaraderie, and all the conversations about biking and dancing and kids and living life and, and, and…. I’ll miss you. You have been like the best of a small town community. I’m not leaving because I want to get away from here. I’m leaving because all sorts of riffs have been playing in my mind, and I want to see which ones are ready to become a melody. Thank you many times over.
Maggie