Melanoma, Patient Care, Perspectives

Permission


“You’re a good man”, said my patient as he hugged me. He was tapping me kindly on my back. He had waited for over an hour to see me. Wheelchair bound I was saddened when I walked in to see him. I was realizing the end was near as the quote of the series Dr. Who flashed through my mind…when The Doctor says….” I am not a good man, but I am not bad man, I am definitely not a president, or a general or an officer…….I am in idiot with a box and a screwdriver, helping out when I can, learning.” The obvious part is that I am helping out when I can, and the rest of the truth is that I am an idiot passing through with the knowledge I have acquired, and learning as I go. I discovered that my patients have been teaching me something they do very well; teaching me how to die. Here he sat in the wheelchair, he looked ready. What was he waiting for?

I have acquired an innate understanding of death. I recognize it, I accept it, and I too am scared of it. It is a stretch to talk about death like we do about life. Death is more inevitable than life itself yet we tend to dismiss it. We focus on life, and on the aspects that are important to develop a career, an education, a pathway and a life, a relationship and a way to replicate ourselves and bring in more lives to this world. But, as I talk to so many who are ready to transition to death, I tend to think of it as a suspension. That is another story for another day. This man was a little different he made a trip to see me, but I am hiding the ending behind the veil, because it is what is making my statement more powerful. He is making me talk about death to you as intimate, as something there, and maybe we should not be dismissing it. We tend to not want to embark on the journey that challenges our intellect or our comfort, or our narcissism. We do not talk about it objectively or even humorously like we do about a thrilling story in Halloween, not every day, not all the time. We do not talk about it with a bit of comradery, or some spirituality, or some vulnerability? “It” is the way we observe it. Why are we talking about Dr. Who?

He sat there. Haggard. I told him it was time to die. That he should be made “Hospice”, that his cancer was everywhere, and that there is nothing I could do. I was sure of that. My mind fighting the words, “We have had this conversation……why did you come?” He gracefully accepted and hugged me. All the people in the room did that. Why so thankful I thought? How could death today not be so familiar to me, I say goodbye to so many. The relationship being re-defined. The news came the next morning, he died early morning peacefully surrounded by his family. I make sure I always ask how. My heart goes out to his family and I was sad. He knew what he was doing. He signaled that he was dying, as if he wanted permission to give in to its call. He wanted to not let me down, not let his family down he was fighting for those around him. Once the news was out, he let go.

I am just passing through, learning from those who travel into the suspension they go.

Mo

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5 thoughts on “Permission

  1. Kathie jessen says:

    A last grasp to avoid the inevitable final goodbye.i sat with my mom for weeks as she faded in her coma .i was prepared.still at her last breathe I ran out of the room looking for a nurse/Doctor to please come help!
    My granddaughter died in utero at eight months.Still I tried to find her heartbeat until her mother said to me”she is gone”.it is human nature not to give up and also to fear the “end” or loss.Mo, you have a tough job.Bless you for giving sucor when we need it.

  2. I should also point out that you are the only one of many of my teachers as a physician who took time to teach of how to be around a dying person, how to respect the one who is about to move on. For that I am very grateful. In the past 4 weeks, I have had several of my patients die. They died in peace and comfort. Without your teaching me, I would’ve been less able to help them.

  3. Patricia Smith-Wahl says:

    Dear Doctor Mo,

    What a beautiful story, thank you for sharing this. May I state my observation? You probably thought of this as well. It sounds as if your patient wanted to spend a little time with you before he left. Perhaps he was saying good bye to you, someone who touched his life profoundly perhaps? He wanted to see you as a kind of closure?

    You seem so humble. I am awed by your willingness as a doctor to be so honest and raw with your thoughts about patient experiences!

    Best Regards,

    Patricia

  4. Claire Barnhouse says:

    Mo,
    As always they just keep getting better and better. We would all be so sad if you quit writing.
    You mean so much to us as patients! I would be the one coming to see you for the last time on my death bed if I had to. Your words mean so much to all of us and we are so greatful we have you fighting to keep us alive. My hat will always go off to you my amazing doctor of science!
    Claire

  5. Marcia Callender says:

    Very touching, I am crying all over my keyboard- because you are a very honest and compassionate caregiver. I am not so afraid my family member will not win the battle, but afraid she will not know when the battle is over. Thanks for helping ease that burden from my mind. keep writing it helps more than you know.

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