Our Chief of Medicine and instructor of clinical skills and diagnosis came to talk to the first year medical students about Internal Medicine. During the small group discussion, someone asked about potentially becoming depressed or disheartened by only seeing dying patients. The physician, however, emphasized that it really has to do with one’s perspective. I’ll try and make an attempt to recreate his perspective because it resonated very much with me and reflects my views:
“Imagine how frightening and intimidating it would be to be suddenly being dropped in a foreign country where you don’t know anything about the language or culture. However, imagine how comforting it would be to run into a friend who knows the place and says to you, “Here, let me show you around.” Everything is still new, but it’s not longer as frightening as it might have been otherwise. While many doctors early in their training try to avoid the patients they know are dying because they see them as reflections on their failures as doctors, I see it as being a privilege to be their guide. Most people only come into intimate contact with death maybe five times during their lifetime (burying parents, a sibling, a spouse, and a friend), and each time may be a very disorienting and new experience. They don’t know where they are going, but you, as a physician, see death all the time. You can say to them, “Hey, I don’t know if there’s anything after this, or maybe there is, and wouldn’t you want to check that out? Either way, you’re scared, right? I’m here to help you through this.”
Helping guide patients through this transition from life to death is as much a motivation for me as are saving lives and improving quality of life for my patients. I know this isn’t something that gets most people out of bed in the morning, but I hope I can do a good job of helping people find the path that is best for them (particularly if I do decide to work in Critical Care and would be in the position of counseling patients on whether or not to continue treatment or withdraw life support).