Saying Goodbye

Just in case I was wondering why I took last night off entirely from studying for no good reason (spending most of the night setting up this blog, presumably to reflect on an informal brownbag chat of which I'll attend 50 gazillion over the course of my training), it just became clear: so that I'd have this infrastructure in place to reflect on what just happened. And I mean JUST happened - I'm writing this during class, because I don't want to let any droplet of this evaporate.

Today I heard the story of an interdisciplinary treatment team collaborating in the care of a woman in the last days of her life. Through the eyes of her caregivers, I appreciated this woman's strength. I was mindful of the inspiration and awe that I've felt before when I've encountered patients who have heroically battled cancer, both successful and not. Reflecting back, I think that inspiration/awe has usually been a manifestation of anxiety and uncertainty: What would I do if this were me? What would I do if this were someone close to me? What would I do if this were my patient? I'm always aware of how I have no idea what I would do -- and, accordingly, admire those who do.

But today, there was a more striking experience. Listening to this story, I felt my body temperature and heart rate rise, my eyes glaze over with a burning sadness, the precursor to sweat beading up -- and, to be honest, 40 minutes later, none of this has waned. Towards the end of the presentation, a woman from the audience raised her hand to speak. She had been this patient's primary nurse during her treatment and reflected on one of her last memories of this patient. Almost as a throw-away line at the end, she used the words: "... and then I said goodbye to her." It hit me that I have NO idea how to handle that situation. I've been fortunate to have never had the experience of having to say goodbye to someone who is dying. I started flashing audio clips through my brain of sample parting lines against a stillframe of a hospital hallway, and interrupted each one with frustration and incompetence. A feeling of profound sadness washed over me.

My friend sitting next to me observed that I was visually shaken, and asked me about this on the way out. I asked her if she had ever had the experience of saying goodbye to someone who is dying. "Not when they were in a state of being aware of what I was saying." I have been fortunate to have not even have had THAT experience...

I think, read, and talk a lot about the challenge of delivering bad news. In fact, I am mostly over my great fear of never learning an appropriate way of doing it -- I'm fairly confident that I will develop something sensititve and effective. But THIS... this, I've never thought about. Why have I never thought about this? I have no idea what I would do or say, and I need to.

I think I want to look into volunteering at a hospice, once I get a better handle on my schedule. Forced immersion in what I am most scared of... there's no doubt that this would be invaluable. I've never done something by CHOICE that I absolutely have no desire to do. Is it foolish? Is it selfish?

I don't know...